Phenotypic spectrum of heart failure with preserved ejection fraction

Heart Fail Clin. 2014 Jul;10(3):407-18. doi: 10.1016/j.hfc.2014.04.008. Epub 2014 May 22.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome, with several underlying etiologic and pathophysiologic factors. The heterogeneity of the HFpEF syndrome may explain why (1) diagnosing and treating HFpEF is so challenging and (2) clinical trials in HFpEF have failed thus far. Here we describe 4 ways of categorizing HFpEF based on pathophysiology, clinical/etiologic subtype, type of clinical presentation, and quantitative phenomics (phenomapping analysis). Regardless of the classification method used, improved phenotypic characterization of HFpEF, and matching targeted therapies with specific HFpEF subtypes, will be a critical step towards improving outcomes in this increasingly prevalent syndrome.

Keywords: Classification; Clinical trials; Etiology; Heart failure with preserved ejection fraction; Pathophysiology; Phenomics; Phenotype.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiotonic Agents / therapeutic use
  • Clinical Trials as Topic
  • Echocardiography, Doppler, Color
  • Female
  • Genetic Predisposition to Disease / epidemiology*
  • Heart Failure / diagnostic imaging
  • Heart Failure / drug therapy*
  • Heart Failure / genetics*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Molecular Targeted Therapy*
  • Phenotype*
  • Prognosis
  • Reference Values
  • Risk Assessment
  • Stroke Volume / physiology*
  • Syndrome
  • Treatment Outcome

Substances

  • Cardiotonic Agents