Heart failure with preserved ejection fraction: insights from recent clinical researches

Kim, Mi-Na; Park, Seong‐Mi

doi:10.3904/kjim.2020.104

Cited by 11 publications

(8 citation statements)

References 119 publications

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“…Approximately half of patients with HF will have a preserved ejection fraction (HFpEF). 5 This is less well understood and less easily diagnosed than HFrEF (reduced ejection fraction). 6 , 7 The diagnosis of HFpEF is challenging particularly at an early stage of the illness where symptoms are nonspecific and can be caused by numerous other non-cardiac conditions, such as chronic lung disease, anaemia, and chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives

et al. 2021

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Objectives To explore the perspectives of general practitioners (GPs) on the identification and management of people, including those from ethnic minority groups, with Heart Failure with Preserved Ejection Fraction (HFpEF). Methods Qualitative study. Semi-structured, face-to-face or telephone interviews and focus groups were conducted with 35 GPs in England, which were audio-recorded and transcribed verbatim. Framework analysis was used to manage and interpret data. Results Themes presented reflect four inter-related challenges: GPs’ 1) lack of understanding HFpEF, impacting on 2) difficulties in communicating the diagnosis, leading to 3) uncertainty in managing people with HFpEF, further hindered by (4) discontinuity across the primary/secondary interface. All were considered more challenging by GPs when managing people from different cultures and languages. Discussion HFpEF is not well understood by GPs, leading to diagnostic difficulty, management uncertainty and potential inequity in care offered. People with HFpEF are seen as complex, with multiple long-term conditions and requiring personalised care. Challenges in their management occur across the healthcare system. This study has identified learning needs for GPs around identification and on-going support for people with HFpEF in primary care. It will contribute to the development of more flexible and patient-centred pathways across the primary/secondary care interface.

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Section: Introductionmentioning

confidence: 99%

Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives

et al. 2021

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“…Considering that systolic functions can be preserved even in serious heart problems, diastolic functions seem to guide us more. 19 In the study, we found that the tricuspid E 0 and A 0 waves were significantly decreased, and the E 0 /A 0 ratio increased significantly in both study groups compared with the control groups. In a study investigating PPROM fetuses with confirmed microbial invasion, changes in diastolic functions were shown with conventional Doppler.…”

Section: Discussionmentioning

confidence: 68%

The Importance of Tissue Doppler Imaging and M‐Mode Ultrasonography in Fetuses With Preterm Premature Rupture of Membranes

Yildirim,

Oluklu,

Menekse Beser

et al. 2023

J of Ultrasound Medicine

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ObjectiveTo compare the cardiac functions of fetuses with preterm premature rupture of membranes (PPROM) between their control groups and investigate its relationship with perinatal outcomes.MethodsThis prospective study was conducted with 102 pregnant women. Pregnant women with PPROM were divided into two subgroups Group A, between 26 and 30 weeks, and Group B, between 30 and 34 weeks. A control group was formed by randomly including one healthy pregnant woman for each study patient. Sociodemographic, obstetric data, tissue Doppler imaging, and M‐mode imaging results were compared. The relationship between echocardiographic parameters and perinatal outcomes was also investigated.ResultsTricuspid annular plane systolic excursion (TAPSE), S′, and ET′ of systolic cardiac parameters were shortened in both groups compared with their controls. Diastolic function indicator E′/A′, and global function indicator myocardial performance index' increased in both groups. Isovolumetric contraction time' did not change between groups. A correlation was found between myocardial performance index', and the length of neonatal intensive care unit stay in Group A and TAPSE and duration of respiratory support and length of neonatal intensive care unit stay in Group B.ConclusionsThe fetal cardiac function seems to be affected by PPROM, and these changes are associated with neonatal outcomes. Therefore, administering fetal cardiac function evaluation in pregnancies complicated by PPROM may help physicians establish more appropriate clinical management protocols in this special population.

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“…HFpEF is a complex entity with many traditional and nontraditional cardiovascular risk factors, such as hypertension (HTN), diabetes mellitus (DM), obesity, renal or pulmonary disease, influencing its pathophysiology. 11 These comorbidities, particularly obesity, induce a systemic proinflammatory state evident from increased circulation of interleukin-6 and tumor necrosis factor alpha (TNF-α). This induces microvascular endothelial cells to produce reactive oxygen species, thus limiting the availability of nitric oxide (NO) for cardiomyocytes.…”

Section: Pathophysiology Of Heart Failure With Preserved Ejection Fractionmentioning

confidence: 99%

Transcatheter Interatrial Shunts for the Treatment of Heart Failure with Preserved Ejection Fraction

Bhardwaj¹,

Parikh²,

Nair³

2021

International Journal of Cardiovascular Sciences

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Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome, which accounts for about 50% of patients with heart failure (HF). The morbidity and mortality associated with HFpEF is similar to HFrEF. Clinical trials to date have failed to show a benefit of medical therapy for HFpEF, which may due to lack of uniform phenotypes and heterogeneous population. In addition, medical therapy proven for HFrEF may not address the pathophysiologic basis for HFpEF. Left atrial remodeling and dysfunction is central to HFpEF and accounts for secondary pulmonary hypertension and pulmonary vascular congestion that frequently occurs with exertion. Interatrial shunts represent a novel treatment modality for HFpEF. These shunts allow for left atrial decongestion and a reduction in pulmonary venous hypertension during exercise leading to improvements in hemodynamics, functional status and quality of life. Trials to date have demonstrated safety and short-term efficacy of these devices for HFpEF. The long-term benefits are currently being evaluated in ongoing trials. If effective, the use of interatrial shunts may be a new therapeutic paradigm for the treatment of HFpEF.

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Heart failure with preserved ejection fraction: insights from recent clinical researches

Cited by 11 publications

References 119 publications

Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives

Challenges in the management of people with heart failure with preserved ejection fraction (HFpEF) in primary care: A qualitative study of general practitioner perspectives

The Importance of Tissue Doppler Imaging and M‐Mode Ultrasonography in Fetuses With Preterm Premature Rupture of Membranes

Transcatheter Interatrial Shunts for the Treatment of Heart Failure with Preserved Ejection Fraction

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