Background:
Heart failure with preserved ejection fraction (HFpEF) is a
multifactorial condition with a variety of pathophysiological causes and
morphological manifestations. The inclusion criteria and patient classification
have become overly simplistic due to the customary differentiation regarding the
ejection fraction (EF) cutoff. EF is considered a measure of systolic function;
nevertheless, it only represents a portion of the true contractile state and has
been shown to have certain limits due to methodological and hemodynamic
irregularities.
Methods:
As a result, broader randomized clinical trials
have yet to incorporate the most recent criteria for HFpEF diagnosis, leading to
a lack of data consistency and confusion in interpreting the results. The primary
variations between the bigger clinical trials published in this context
concerning patient selection and echocardiographic characteristics were analyzed.
For all these reasons, we aim to clarify the main features and clinical impact of
HFpEF in a study combining imaging, bio-humoral analysis, and clinical history to
identify the specific subgroups that respond better to tailored treatment.
Results:
Disparate clinical characteristics and a lack of uniform
diagnostic standards may cause suboptimal therapeutic feedback. To optimize
treatment, we suggest shifting the paradigm from the straightforward EF
measurement to a more comprehensive model that considers additional information,
such as structural traits, related disorders, and biological and environmental
data. Therefore, by evaluating certain echocardiographic and clinical factors, a
stepwise diagnostic procedure may be useful in identifying patients at high risk,
subjects with early HFpEF, and those with evident HFpEF.
Conclusions:
The present assessment underscores the significance of the precision medicine
approach in guaranteeing optimal patient outcomes by providing the best care
according to each distinct profile.