TY - JOUR
T1 - Understanding heart failure with preserved ejection fraction
T2 - Clinical importance and future outlook
AU - Miller, Alan B.
AU - Piña, Ileana L.
PY - 2009
Y1 - 2009
N2 - Heart failure (HF) with preserved ejection fraction (HF-PEF) accounts for approximately one half of all HF patients admitted with acute decompensated HF and carries a significant morbidity and mortality burden. This condition, however, has been largely understudied because it is difficult to diagnose, and management guidelines are still being discussed. This article provides an overview of HF-PEF and its pathophysiology, diagnosis, and treatment, with a focus on clinical trials using renin-angiotensin-aldosterone system (RAAS) blockers. Inhibitors of the RAAS have been studied in HF-PEF to determine whether their benefits extend beyond blood pressure control. However, the 3 trials conducted to date (CHARM-Preserved, PEP-CHF, and I-PRESERVE) with candesartan, perindopril, and irbesartan, have failed to demonstrate significant morbidity and mortality benefits. Although no agent has proven statistically significant benefits in morbidity and mortality in HF-PEF, recent studies have added to the breadth of clinical data and understanding of the demographics of these patients.
AB - Heart failure (HF) with preserved ejection fraction (HF-PEF) accounts for approximately one half of all HF patients admitted with acute decompensated HF and carries a significant morbidity and mortality burden. This condition, however, has been largely understudied because it is difficult to diagnose, and management guidelines are still being discussed. This article provides an overview of HF-PEF and its pathophysiology, diagnosis, and treatment, with a focus on clinical trials using renin-angiotensin-aldosterone system (RAAS) blockers. Inhibitors of the RAAS have been studied in HF-PEF to determine whether their benefits extend beyond blood pressure control. However, the 3 trials conducted to date (CHARM-Preserved, PEP-CHF, and I-PRESERVE) with candesartan, perindopril, and irbesartan, have failed to demonstrate significant morbidity and mortality benefits. Although no agent has proven statistically significant benefits in morbidity and mortality in HF-PEF, recent studies have added to the breadth of clinical data and understanding of the demographics of these patients.
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U2 - 10.1111/j.1751-7133.2009.00063.x
DO - 10.1111/j.1751-7133.2009.00063.x
M3 - Review article
C2 - 19627293
AN - SCOPUS:67651162426
SN - 1527-5299
VL - 15
SP - 186
EP - 192
JO - Congestive Heart Failure
JF - Congestive Heart Failure
IS - 4
ER -