Heart failure with preserved ejection fraction (HFpEF), also called diastolic heart failure, is a type of heart failure in which the heart has difficulty filling with blood during the relaxation phase (diastole), even when the ejection fraction remains normal or near-normal. What you need to know about HFpEF:
Causes
HFpEF is often caused by a number of factors, including:
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Blood pressure (hypertension)
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The disease of the coronary arteries
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Diabetes
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Obesity
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Age-related changes in the heart muscle
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Valvular heart disease
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Chronic kidney disease
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Sleep apnea
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Chronic obstructive pulmonary disease (COPD)
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Cardiomyopathies (diseases of the heart muscle)
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Inflammatory conditions affecting the heart
Symptoms
The following symptoms may be associated with HFpEF:
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Physical exertion or lying flat can cause shortness of breath
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Fatigue
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Swelling in the legs, ankles, or abdomen (edema)
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Rapid or irregular heartbeat
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Persistent cough or wheezing
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Difficulty exercising
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Reduced ability to tolerate physical activity
Diagnosis
HFpEF is typically diagnosed by:
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A healthcare provider will assess a patient's symptoms, medical history, and risk factors for heart disease.
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To evaluate heart function, assess for structural abnormalities, and rule out other conditions, diagnostic tests include echocardiograms, electrocardiograms, stress tests, cardiac MRIs, and blood tests.
Treatment
Treatment for HFpEF is aimed at relieving symptoms, improving quality of life, and reducing complications. It may include:
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Modify your lifestyle by eating a heart-healthy diet, exercising regularly, managing stress, maintaining a healthy weight, and not smoking or drinking excessively.
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Diauretics (water pills) are used to reduce fluid buildup, blood pressure medications are used to control blood pressure and heart rate medications are used to control heart rate and rhythm.
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Treating underlying conditions such as hypertension, diabetes, and coronary artery disease can improve heart function and symptoms.
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The use of devices such as pacemakers or implantable cardioverter-defibrillators (ICDs) may be recommended in some cases to help regulate heart rhythms or prevent sudden cardiac death.
Prevention
Hypertension, diabetes, obesity, and sedentary lifestyles are modifiable risk factors that contribute to HFpEF prevention. It is possible to reduce the risk of developing heart failure and its complications by adopting a heart-healthy lifestyle, which includes regular exercise, maintaining a balanced diet, managing stress, and avoiding tobacco use.
Conclusion
Heart failure with preserved ejection fraction (HFpEF) is a complex condition characterized by impaired heart relaxation despite a normal or near-normal ejection fraction. For prevention and management of HFpEF, it is essential to address modifiable risk factors and optimize management of underlying conditions. With lifestyle modifications, medications, and device therapy as needed, HFpEF is treated to relieve symptoms, improve quality of life, and reduce the risk of complications.
