Heart 2009;95:1549-1552
Featured editorial
Heart failure with a normal ejection fraction: new developments
1 Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Peoples’ Republic of China
2 Department of Cardiovascular Medicine, University of Birmingham, Birmingham, UK
Correspondence to Professor J E Sanderson, Department of Cardiovascular Medicine, University of Birmingham, Birmingham B15 2TT, UK; j.e.sanderson@bham.ac.uk
| The first 150 words of the full text of this article appear below. |
About half of patients with symptoms and signs of heart failure will be found to have a normal or near-normal left ventricular ejection fraction (LVEF). These patients are mostly elderly women, and the majority have a history of hypertension in contrast to a predominantly ischaemic aetiology in those with heart failure and a reduced ejection fraction (HFREF). Heart failure with a normal ejection fraction (HFNEF) is proving to be intriguing with only a few established facts but many myths. First, the precise underlying pathophysiology is still debated. Recent work has demonstrated that abnormalities exist in LV systolic properties, ventricular–arterial coupling, LV diastolic function, torsion or twist, ventricular–ventricular interaction, pericardial constraint, with impaired chronotropic, vasodilator reserves and pulmonary hypertension. Thus, the term HFNEF is preferred rather than diastolic heart failure (DHF) as the term DHF implies that the primary or dominant abnormality is in diastole alone to which treatment should be
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- Management of heart failure with preserved ejection fraction: back to the drawing board?
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