Publication: Managing Heart Failure with Preserved Ejection Fraction; A Short Review of Latest Evidences
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Heart failure with preserved ejection fraction (HFpEF) is a clinical dilemma and
various clinical trials so far have failed to give a concrete evidence of reducing
mortality and major adverse cardiac events (MACE) in this condition. A detailed
analysis of the existing evidences and a future plan for a concrete trial design with
long duration of follow up is needed to address the dilemma of Heart failure with
preserved ejection fraction.
The objective of this short review was to review the latest and major randomized
controlled trials and study the primary outcomes. The public database of PubMed,
Google Scholar and Cochrane were extensively searched for all randomized
controlled trials using keywords of Heart failure with preserved ejection fraction,
major adverse cardiac events, Hospitalizations; and studies were included in the
review if data were reported for patients with ejection fraction > 40%, did not
include congenital heart disease, and demonstrated evidence of diastolic failure
on echocardiogram (ECHO), and evaluated hospitalizations, major adverse cardiac
events and cardiovascular mortality.
Despite the major trials reporting improved primary composite endpoints with
newer drugs the results have to be interpreted cautiously since the primary
outcome were mostly driven by heart failure hospitalizations and not mortality
reduction.
KEY WORDS
Diastolic dysfunction, Heart failure, Heart failure with preserved ejection fraction,
Preserved left ventricular function, SGLT2
Description
Mahaseth A,1 Karki P2
1Department of Cardiology
Shahid Gangalal National Heart Centre
Bansbari, Kathmandu, Nepal
2Department of Cardiology
B.P. Koirala Institute of Health Sciences
Dharan, Nepal
Keywords
Diastolic dysfunction, Heart failure, Heart failure with preserved ejection fraction, Preserved left ventricular function, SGLT2