State-of-the-Art ReviewHow to Manage Heart Failure With Preserved Ejection Fraction: Practical Guidance for Clinicians
Central Illustration
Section snippets
General approach to management
In practice, the management of HFpEF is based on the following principles: 1) establish the diagnosis of HF and exclude potentially treatable alternatives; 2) institute general measures to manage congestion and address comorbidities/precipitating factors; and 3) initiate evidence-based medical therapy.
Conclusions
A suggested algorithm for HFpEF treatment is outlined in the Central Illustration. Following confirmation of the diagnosis and exclusion of alternatives, treatment should focus on decongestion and optimal management of cardiac and noncardiac comorbidities. Aggressive treatment of blood pressure to guideline recommended targets is appropriate for all patients; coronary revascularization is appropriate for those with ischemic symptoms, and a trial of sinus rhythm maintenance/restoration may be
Funding Support and Author Disclosures
Dr Desai has received institutional research grants from AstraZeneca, Abbott, Alnylam, Bayer, and Novartis; has received consulting fees from Abbott, Alnylam, AstraZeneca, Axon Therapeutics, Avidity Biopharma, Bayer, Biofourmis, Cytokinetics, GlaxoSmithKline, Medpace, Merck, New Amsterdam, Novartis, Parexel, Roche, Regeneron, Veristat, and Verily. Dr Lam has received a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Bayer and
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Barry Borlaug, MD, served as Guest Associate Editor for this paper. Barry Greenberg, MD, served as Guest Editor-in-Chief for this paper.
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