Heart Failure With Preserved Ejection Fraction

Heart failure with preserved ejection fraction, or HFpEF, is a form of heart failure caused primarily by impaired ventricular relaxation and reduced left ventricular compliance despite a preserved ejection fraction.

In this episode, Chris and Mars review:

• Why a normal ejection fraction does not mean normal cardiac function
• The classic HFpEF patient: older adults with hypertension, obesity, diabetes, chronic kidney disease, or atrial fibrillation
• The role of concentric left ventricular hypertrophy and diastolic dysfunction
• Classic symptoms and physical exam findings, including the S four
• How HFpEF is diagnosed using clinical heart failure plus evidence of elevated filling pressures or diastolic dysfunction
• Why obesity can lower B N P levels
• S G L T two inhibitors as foundational therapy
• Loop diuretics for congestion and the importance of blood pressure control
• Why HFpEF treatment should not simply copy the HFrEF medication regimen
• Management of associated conditions including atrial fibrillation, obesity, kidney disease, coronary disease, and sleep apnea

Episode pearl: Preserved ejection fraction does not mean preserved cardiac function. HFpEF is a filling-pressure problem caused by a stiff, poorly relaxing ventricle.

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