Evolving Approaches to the Management of Heart Failure with Preserved Ejection Fraction in Patients with Coronary Artery Disease

Overview

Journal Curr Treat Options Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2010 Sep 16

PMID 20842482

Citations 13

Authors

Sanjiv J Shah

Affiliations

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Abstract

Coronary artery disease (CAD) is a major cause of heart failure with preserved ejection fraction (HFpEF). In studies of HFpEF, the reported prevalence of CAD varies widely, which may be the result of inconsistent definitions of CAD, geographic and ethnic differences in CAD burden, varying definitions of HFpEF (including different cutoffs for "preserved ejection fraction"), and differences in study design. Despite these limitations, pooled analysis of prospective HFpEF studies demonstrates that CAD is common in HFpEF, with an estimated prevalence of approximately 50%. Based on available data, patients with signs and symptoms of heart failure who have preserved left ventricular ejection fraction and evidence of CAD (HFpEF-CAD) most likely comprise a distinct etiologic and pathophysiologic subset of HFpEF. Therefore, future clinical trials in HFpEF should a priori stratify by CAD or specifically target patients with CAD, strategies that may improve the disappointing track record of therapies tested in HFpEF. The combination of systematic evaluation and management of CAD in HFpEF, along with promising future therapies for HFpEF-CAD, may lead to improved outcomes for this challenging clinical syndrome.

Citing Articles

Coronary Artery Disease and Heart Failure With Preserved Ejection Fraction: The ARIC Study.

John J, Claggett B, Skali H, Solomon S, Cunningham J, Matsushita K J Am Heart Assoc. 2022; 11(17):e021660.

PMID: 36000416 PMC: 9496411. DOI: 10.1161/JAHA.121.021660.

Natriuretic Peptide Clearance Receptor (NPR-C) Pathway as a Novel Therapeutic Target in Obesity-Related Heart Failure With Preserved Ejection Fraction (HFpEF).

Eroume A Egom E Front Physiol. 2021; 12:674254.

PMID: 34093235 PMC: 8176210. DOI: 10.3389/fphys.2021.674254.

Current Management and Future Directions of Heart Failure With Preserved Ejection Fraction: a Contemporary Review.

Krittanawong C, Kukin M Curr Treat Options Cardiovasc Med. 2018; 20(4):28.

PMID: 29557071 DOI: 10.1007/s11936-018-0623-1.

Diagnostic and prognostic utility of cardiovascular magnetic resonance imaging in heart failure with preserved ejection fraction - implications for clinical trials.

Kanagala P, Cheng A, Singh A, McAdam J, Marsh A, Arnold J J Cardiovasc Magn Reson. 2018; 20(1):4.

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Novel plasma and imaging biomarkers in heart failure with preserved ejection fraction.

Kanagala P, Squire I, Ng L, McCann G Int J Cardiol Heart Vasc. 2017; 9:55-62.

PMID: 28785707 PMC: 5497340. DOI: 10.1016/j.ijcha.2015.07.004.

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