Heart failure with preserved ejection fraction

Heart failure with preserved ejection fraction (HFpEF) is a form of congestive heart failure in which the amount of blood pumped from the heart's left ventricle with each beat remains greater than 50%.[1] Approximately 50% of people with heart failure have the preserved ejection fraction type.[1]

HFpEF is characterized by an increase in the stiffness of the heart's left ventricle and a decrease in left ventricle relaxation when filling with blood before the next beat.[2] Increased left atrial size is often seen with HFpEF as a result of the poor left ventricular function. There is an increased risk for atrial fibrillation and pulmonary hypertension. Risk factors for HFpEF include hypertension, hyperlipidemia, diabetes, smoking, and obstructive sleep apnea. There is a query about how this rendering may describe diastolic heart failure.[3]

Causes

Senile systemic amyloidosis, resulting from accumulation of aggregated wild-type transthyretin as part of the degenerative aging process, is emerging as an important and underdiagnosed contributor to HFpEF with age.[4][5]

Diagnosis

HFpEF is best tested-for by analyzing diastolic function during exercise.[6]

Treatment

Despite the rising incidence of the condition, and serious morbidity and mortality associated with the disease, trials of therapy have largely been negative. Understanding and targeting mechanisms will be key to effective therapy.[7] Randomized studies on HFpEF patients have shown that exercise has a positive lusitropic effect on left ventricular diastolic function (that is, it improves the ability of the left ventricle to relax after contraction), associated with improved aerobic exercise capacity.[8]

See also

References

  1. 1 2 Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006). "Trends in prevalence and outcome of heart failure with preserved ejection fraction". The New England Journal of Medicine. 355 (3): 251–59. doi:10.1056/nejmoa052256. PMID 16855265.
  2. ↑ Redfield, Margaret (10 November 2016). "Heart Failure with Preserved Ejection Fraction". New England Journal of Medicine. 375 (19): 1868-77. doi:10.1056/NEJMcp1511175.
  3. ↑ "Heart failure with preserved ejection fraction: is this diastolic heart failure?". Retrieved February 16, 2012.
  4. ↑ González-López E, Gallego-Delgado M, Guzzo-Merello G, de Haro-Del Moral FJ, Cobo-Marcos M, Robles C, Bornstein B, Salas C, Lara-Pezzi E, Alonso-Pulpon L, Garcia-Pavia P (7 October 2015). "Wild-type transthyretin amyloidosis as a cause of heart failure with preserved ejection fraction". Eur Heart J. 36 (38): 2585–94. doi:10.1093/eurheartj/ehv338. PMID 26224076.
  5. ↑ Mohammed SF, Mirzoyev SA, Edwards WD, Dogan A, Grogan DR, Dunlay SM, Roger VL, Gertz MA, Dispenzieri A, Zeldenrust SR, Redfield MM (April 2014). "Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction". JACC Heart Fail. 2 (2): 113–22. doi:10.1016/j.jchf.2013.11.004. PMC 3984539Freely accessible. PMID 24720917.
  6. ↑ Erdei T, Aakhus S, Marino P, Paulus WJ, Smiseth OA, Fraser AG (2015). "Pathophysiological rationale and diagnostic targets for diastolic stress testing". Heart (journal). 101 (17): 1355–60. doi:10.1136/heartjnl-2014-307040. PMID 26001845.
  7. ↑ Nanayakkara S, Kaye DM (2015). "Management of heart failure with preserved ejection fraction: a review.". Clinical Therapeutics. 37 (10): 2186–2198. doi:10.1016/j.clinthera.2015.08.005. PMID 26385583. PMID 26385583.
  8. ↑ Gielen S, Laughlin MH, O'Conner C, Duncker DJ (2015). "Exercise training in patients with heart disease: review of beneficial effects and clinical recommendations" (PDF). Progress in Cardiovascular Diseases. 57 (4): 347–355. doi:10.1016/j.pcad.2014.10.001. PMID 25459973.

External links

This article is issued from Wikipedia - version of the 11/30/2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.