Heart failure with preserved ejection fraction: Current understandings and challenges

Current Cardiology Reports

Volumn 16, Issue 7, 2014, Pages

  Andersen, Mads J ^a,b   Borlaug, Barry A ^a  

^a MAYO CLINIC   (United States)

^b AARHUS UNIVERSITY HOSPITAL   (Denmark)

Author keywords

Diastolic dysfunction; Diastolic heart failure; Heart failure; Heart failure with preserved ejection fraction; Hemodynamics; Ventricular function

Indexed keywords

CANDESARTAN; IRBESARTAN; NEBIVOLOL; PERINDOPRIL; PLACEBO; SILDENAFIL; SPIRONOLACTONE;

ANEMIA; BLOOD PRESSURE REGULATION; COMORBIDITY; CORONARY ARTERY DISEASE; DISEASE ASSOCIATION; DYSPNEA; EXERCISE TOLERANCE; FATIGUE; HEART FAILURE WITH PRESERVED EJECTION FRACTION; HUMAN; HYPERTENSION; KINESIOTHERAPY; PATHOPHYSIOLOGY; REVIEW; SLEEP DISORDERED BREATHING; SYMPTOM ASSESSMENT; TREATMENT PLANNING; HEART FAILURE; HEART LEFT VENTRICLE FUNCTION; HEART STROKE VOLUME; PHYSIOLOGY; TREATMENT OUTCOME;

HEART FAILURE; HUMANS; STROKE VOLUME; TREATMENT OUTCOME; VENTRICULAR FUNCTION, LEFT;

EID: 84901728615     PISSN: 15233782     EISSN: 15343170     Source Type: Journal    
DOI: 10.1007/s11886-014-0501-8     Document Type: Review

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96. Hernandez AF, Hammill BG, O'Connor CM, Schulman KA, Curtis LH, Fonarow GC. Clinical effectiveness of beta-blockers in heart failure: findings from the OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) Registry. J Am Coll Cardiol. 2009;53:184-92. doi:10.1016/j.jacc.2008.09.031.
97. Redfield MM, Borlaug BA, Lewis GD,Mohammed SF, Semigran MJ, Lewinter MM, et al. PhosphdiesteRasE-5 Inhibition to Improve CLinical Status and eXercise Capacity in Diastolic Heart Failure (RELAX) trial: rationale and design. Circ Heart Fail. 2012;5:653-9. doi:10.1161/CIRCHEARTFAILURE.112.969071.
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99. •• Edelmann F, Gelbrich G, Dungen HD, Frohling S, Wachter R, Stahrenberg R, et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol. 2011;58:1780-91. doi:10.1016/j.jacc.2011.06.054. This is another trial of exercise training in HFpEF and in addition to improved aerobic capacity, the authors noted improvements in echo-Doppler estimates of diastolic function, suggesting a direct myocardial effect from training.
100. Haykowsky MJ, Brubaker PH, Stewart KP, Morgan TM, Eggebeen J, Kitzman DW. Effect of endurance training on the determinants of peak exercise oxygen consumption in elderly patients with stable compensated heart failure and preserved ejection fraction. J Am Coll Cardiol. 2012;60:120-8. doi:10.1016/j.jacc.2012.02.055.
101. • Hummel SL, Seymour EM, Brook RD, Sheth SS, Ghosh E, Zhu S, et al. Low-sodium DASH diet improves diastolic function and ventricular-arterial coupling in hypertensive heart failure with preserved ejection fraction. Circ Heart Fail. 2013;6:1165-71. doi:10.1161/CIRCHEARTFAILURE.113.000481. This small, noncontrolled study observed significant improvements in cardiac function with salt restriction as part of the DASH diet.
102. • Ather S, Chan W, Bozkurt B, Aguilar D, Ramasubbu K, Zachariah AA, et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved vs reduced ejection fraction. J Am Coll Cardiol. 2012;59:998-1005. doi:10.1016/j.jacc.2011. 11.040. This paper highlights the importance of comorbidities in patients with HFpEF in a predominantly male VA population.
103. Shah SJ, Gheorghiade M. Heart failure with preserved ejection fraction: treat now by treating comorbidities. JAMA. 2008;300:431-3. doi:10.1001/jama.300. 4.431. (Pubitemid 352040255)
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105. • Zakeri R, Borlaug BA, McNulty S, Mohammed SF, Lewis GD, Semigran MJ, et al. Impact of atrial fibrillation on exercise capacity in heart failure with preserved ejection fraction: a RELAX trial ancillary study. Circ Heart Fail. 2014 Jan;7(1):123-30. doi:10.1161/CIRCHEARTFAILURE.113.000568. This study shows how atrial fibrillation is associated with more severe exercise limitation in people with HFpEF.
106. Olsson LG, Swedberg K, Ducharme A, Granger CB, Michelson EL, McMurray JJ, et al. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: results from the Candesartan in Heart failure- Assessment of Reduction in Mortality and morbidity (CHARM) program. J Am Coll Cardiol. 2006;47:1997-2004. doi:10.1016/j.jacc.2006. 01.060.
107. Mentz RJ, Broderick S, Shaw LK, Fiuzat M, O'Connor CM. Heart failure with preserved ejection fraction: comparison of patients with and without angina pectoris (from the duke databank for cardiovascular disease). J Am Coll Cardiol. 2014;63:251-8. doi: 10.1016/j.jacc.2013.09.039.
108. Tribouilloy C, Rusinaru D,Mahjoub H, Souliere V, Levy F, Peltier M, et al. Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study. Eur Heart J. 2008;29:339-47. doi:10.1093/eurheartj/ehm554. (Pubitemid 351197754)
109. Choudhury L, Gheorghiade M, Bonow RO. Coronary artery disease in patients with heart failure and preserved systolic function. Am J Cardiol. 2002;89:719-22. (Pubitemid 34230569)
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111. von Haehling S, van Veldhuisen DJ, Roughton M, Babalis D, de Boer RA, Coats AJ, et al. Anemia among patients with heart failure and preserved or reduced ejection fraction: results from the SENIORS study. Eur J Heart Fail. 2011;13:656-63. doi:10.1093/eurjhf/hfr044.
112. • Maurer MS, Teruya S, Chakraborty B, Helmke S, Mancini D. Treating anemia in older adults with heart failure with a preserved ejection fraction with epoetin alfa: single-blind randomized clinical trial of safety and efficacy. Circ Heart Fail. 2013;6:254-63. doi: 10.1161/CIRCHEARTFAILURE.112. 969717. This small randomized trial tested epoetin alfa in anemic patients with HFpEF.
113. Schwarz K, Siddiqi N, Singh S, Neil CJ, Dawson DK, Frenneaux MP. The breathing heart - mitochondrial respiratory chain dysfunction in cardiac disease. Int J Cardiol. 2014;171:134-43. doi:10.1016/j.ijcard.2013.12.014.
114. • Beadle RM, Frenneaux M. Modification of myocardial substrate utilization: a new therapeutic paradigm in cardiovascular disease. Heart. 2010;96:824-30. doi:10.1136/hrt.2009.190256. This interesting article deals with the therapeutic potential for altering myocardial metabolism as a novel approach to treat heart failure.
115. •• Loffredo FS, Steinhauser ML, Jay SM, Gannon J, Pancoast JR, Yalamanchi P, et al. Growth differentiation factor 11 is a circulating factor that reverses age-related cardiac hypertrophy. Cell. 2013;153:828-39. doi:10.1016/j.cell.2013.04.015. This is a basic science paper using a novel parabiosis technique to identify a new molecule involved in maintaining ventricular "youth" and preventing hypertrophic remodeling.
116. Willis MS, Patterson C. Proteotoxicity and cardiac dysfunction - Alzheimer 's disease of the heart? N Engl J Med. 2013;368:455-64. doi:10.1056/NEJMra1106180.
117. Haykowsky MJ, Brubaker PH, Morgan TM, Kritchevsky S, Eggebeen J, Kitzman DW. Impaired aerobic capacity and physical functional performance in older heart failure patients with preserved ejection fraction: role of lean body mass. J Gerontol A Biol Sci Med Sci. 2013;68:968-75. doi:10.1093/gerona/glt011.