Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
High Blood Pressure & Cardiovascular Prevention
Published in: High Blood Pressure & Cardiovascular Prevention 2/2024

Open Access 15-03-2024 | Heart Failure | Review article

Novel Strategies in Diagnosing Heart Failure with Preserved Ejection Fraction: A Comprehensive Literature Review

Authors: Costantino Mancusi, Christian Basile, Carmen Spaccarotella, Giuseppe Gargiulo, Ilaria Fucile, Stefania Paolillo, Paola Gargiulo, Ciro Santoro, Lina Manzi, Federica Marzano, Pasquale Ambrosino, Nicola De Luca, Giovanni Esposito

Published in: High Blood Pressure & Cardiovascular Prevention | Issue 2/2024

Login to get access

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is a prevalent global condition affecting approximately 50% of the HF population. With the aging of the worldwide population, its incidence and prevalence are expected to rise even further. Unfortunately, until recently, no effective medications were available to reduce the high mortality and hospitalization rates associated with HFpEF, making it a significant unmet need in cardiovascular medicine. Although HFpEF is commonly defined as HF with normal ejection fraction and elevated left ventricular filling pressure, performing invasive hemodynamic assessments on every individual suspected of having HFpEF is neither feasible nor practical. Consequently, several clinical criteria and diagnostic tools have been proposed to aid in diagnosing HFpEF. Overall, these criteria and tools are designed to assist healthcare professionals in identifying and evaluating patients who may have HFpEF based on a combination of signs, symptoms, biomarkers, and non-invasive imaging findings. By employing these non-invasive diagnostic approaches, clinicians can make informed decisions regarding the best pharmacological and rehabilitation strategies for individuals with suspected HFpEF. This literature review aims to provide an overview of all currently available methods for diagnosing and monitoring this disabling condition.
Literature
1.
Seferović PM, Vardas P, Jankowska EA, et al. The Heart Failure Association Atlas: heart failure epidemiology and management statistics 2019. Eur J Heart Fail. 2021;23(6):906–14.PubMedCrossRef
2.
Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomized controlled trials. Lancet. 2022;400(10354):757–67.PubMedCrossRef
3.
Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Eur J Heart Fail. 2008;10(10):933–89.PubMedCrossRef
4.
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur J Heart Fail. 2016;18(8):891–975.PubMedCrossRef
5.
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for diagnosing and treating acute and chronic heart failure. Eur Heart J. 2021;42(36):3599–726.PubMedCrossRef
6.
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: a Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895–1032.PubMed
7.
Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022;400(10354):757–67.PubMedCrossRef
8.
Gallo G, Tocci G, Fogacci F, Battistoni A, Rubattu S, Volpe M. Blockade of the neurohormonal systems in heart failure with preserved ejection fraction: a contemporary meta-analysis. Int J Cardiol. 2020;316:172–9.PubMedCrossRef
9.
Basile C, Paolillo S, Gargiulo P, et al. Sacubitril/valsartan reduces cardiac decompensation in heart failure with preserved ejection fraction: a meta-analysis. J Cardiovasc Med (Hagerstown). 2023;24(1):44–51.PubMedCrossRef
10.
Savarese G, Stolfo D, Sinagra G, Lund LH. Heart failure with mid-range or mildly reduced ejection fraction. Nat Rev Cardiol. 2022;19(2):100–16.PubMedCrossRef
11.
Stolfo D, Fabris E, Lund LH, Savarese G, Sinagra G. From mid-range to mildly reduced ejection fraction heart failure: a call to treat. Eur J Intern Med. 2022;103:29–35.PubMedCrossRef
12.
Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018;138(9):861–70.PubMedPubMedCentralCrossRef
13.
Pieske B, Tschöpe C, de Boer RA, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40(40):3297–317.PubMedCrossRef
14.
Amanai S, Harada T, Kagami K, et al. The H2FPEF and HFA-PEFF algorithms for predicting exercise intolerance and abnormal hemodynamics in heart failure with preserved ejection fraction. Sci Rep. 2022;12(1):13.PubMedPubMedCentralCrossRef
15.
Churchill TW, Li SX, Curreri L, et al. Evaluation of 2 existing diagnostic scores for heart failure with preserved ejection fraction against a comprehensively phenotyped cohort. Circulation. 2021;143(3):289–91.PubMedPubMedCentralCrossRef
16.
Thibodeau JT, Drazner MH. The role of the clinical examination in patients with heart failure. JACC Heart Fail. 2018;6(7):543–51.PubMedCrossRef
17.
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson W. AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895–1032.PubMed
18.
Yancy CW, Lopatin M, Stevenson LW, De Marco T, Fonarow GC, Investigators. ADHERE Scientific Advisory Committee and Clinical presentation, management, and in-hospital outcomes of patients admitted with acute decompensated heart failure with preserved systolic function: a report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. J Am Coll Cardiol. 2006;47(1):76–84.PubMedCrossRef
19.
Solomon SD, Rizkala AR, Lefkowitz MP, Shi VC, Gong J, Anavekar N, Anker SD, Arango JL, Arenas JL, Atar D, Ben-Gal T, Boytsov SA, Chen CH, Chopra VK, Cleland J, Comin-Colet J, Duengen HD, Echeverría Correa LE, Filippatos G, Flammer AJ, Galinier M, Godoy A. Baseline characteristics of patients with heart failure and preserved ejection fraction in the PARAGON-HF trial. Circ Heart Fail. 2018;11(7): e004962.PubMedCrossRef
20.
Drazner MH, Prasad A, Ayers C, Markham DW, Hastings J, Bhella PS, Shibata S, Levine BD. The relationship of right- and left-sided filling pressures in patients with heart failure and a preserved ejection fraction. Circ Heart Fail. 2010;3(2):202–6.PubMedPubMedCentralCrossRef
21.
Jering K, Claggett B, Redfield MM, Shah SJ, Anand IS, Martinez F, Sabarwal SV, Seferović PM, Kerr Saraiva JF, Katova T, Lefkowitz MP, Pfeffer MA. Burden of heart failure signs and symptoms, prognosis, and response to therapy: the PARAGON-HF trial. JACC Heart Fail. 2021;9(5):386–97.PubMedCrossRef
22.
23.
Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E, Edelmann F, Fu M, Guazzi M, Lam CSP, Lancellotti P, Melenovsky V, Morris DA, Nagel E, Pieske-Kraigher E, Ponikowski P, Solomon SD, Vasan RS, Rutten FH, Voors AA, Ruschitzka F, Paulus WJ, Sefer P. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019;40(40):3297–317.PubMedCrossRef
24.
Smiseth OA, Morris DA, Cardim N, et al. Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2022;23(2):e34–61.PubMedCrossRef
25.
Perrone-Filardi P, Paolillo S, Agostoni P, et al. Renin-angiotensin-aldosterone system inhibition in patients affected by heart failure: efficacy, mechanistic effects and practical use of sacubitril/valsartan. Position Paper of the Italian Society of Cardiology. Eur J Intern Med. 2022;102:8–16.PubMedCrossRef
26.
Elmadi J, Satish Kumar L, Pugalenthi LS, Ahmad M, Reddy S, Barkhane Z. Cardiovascular magnetic resonance imaging: a prospective modality in the diagnosis and prognostication of heart failure. Cureus. 2022;14(4): e23840.PubMedPubMedCentral
27.
Quarta G, Gori M, Iorio A, et al. Cardiac magnetic resonance in heart failure with preserved ejection fraction: myocyte, interstitium, microvascular, and metabolic abnormalities. Eur J Heart Fail. 2020;22(7):1065–75.PubMedCrossRef
28.
Del Torto A, Guaricci AI, Pomarico F, et al. Advances in multimodality cardiovascular imaging in the diagnosis of heart failure with preserved ejection fraction. Front Cardiovasc Med. 2022;9: 758975.PubMedPubMedCentralCrossRef
29.
Gargiulo P, Acampa W, Asile G, et al. 123I-MIBG imaging in heart failure: impact of comorbidities on cardiac sympathetic innervation. Eur J Nucl Med Mol Imaging. 2023;50(3):813–24.PubMedCrossRef
30.
Seo M, Yamada T, Tamaki S, et al. Prognostic significance of cardiac 123I-MIBG SPECT imaging in heart failure patients with preserved ejection fraction. JACC Cardiovasc Imaging. 2022;15(4):655–68.PubMedCrossRef
31.
Volpe M, Gallo G, Rubattu S. Endocrine functions of the heart: from bench to bedside. Eur Heart J. 2023;44(8):643–55.PubMedCrossRef
32.
Goetze JP, Bruneau BG, Ramos HR, Ogawa T, de Bold MK, de Bold AJ. Cardiac natriuretic peptides. Nat Rev Cardiol. 2020;17(11):698–717.PubMedCrossRef
33.
Gallo G, Rubattu S, Autore C, Volpe M. Natriuretic peptides: it is time for guided therapeutic strategies based on their molecular mechanisms. Int J Mol Sci. 2023;24(6):5131.PubMedPubMedCentralCrossRef
34.
Grewal J, McKelvie RS, Persson H, et al. Usefulness of N-terminal pro-brain natriuretic Peptide and brain natriuretic peptide to predict cardiovascular outcomes in patients with heart failure and preserved left ventricular ejection fraction. Am J Cardiol. 2008;102(6):733–7.PubMedCrossRef
35.
Dal Canto E, Scheffer M, Kortekaas K, Driessen-Waaijer A, Paulus WJ, van Heerebeek L. Natriuretic peptide levels and stages of left ventricular dysfunction in heart failure with preserved ejection fraction. Biomedicines. 2023;11(3):867.PubMedPubMedCentralCrossRef
36.
Kasahara S, Sakata Y, Nochioka K, et al. Comparable prognostic impact of BNP levels among HFpEF, borderline HFpEF and HFrEF: a report from the CHART-2 Study. Heart Vessels. 2018;33(9):997–1007.PubMedCrossRef
37.
Anjan VY, Loftus TM, Burke MA, et al. Prevalence, clinical phenotype, and outcomes associated with normal B-type natriuretic peptide levels in heart failure with preserved ejection fraction. Am J Cardiol. 2012;110(6):870–6.PubMedPubMedCentralCrossRef
38.
Remmelzwaal S, van Ballegooijen AJ, Schoonmade LJ, Dal Canto E, Handoko ML, Henkens MTHM, van Empel V, Heymans SRB, Beulens JWJ. Natriuretic peptides for the detection of diastolic dysfunction and heart failure with preserved ejection fraction-a systematic review and meta-analysis. BMC Med. 2020;18(1):290.PubMedPubMedCentralCrossRef
39.
Hund PS, Anand IS, Komajda M, Claggett BL, McKelvie RS, Zile MR, Carson PE, McMurray JJ. Changes in N-terminal pro-B-type natriuretic peptide levels and outcomes in heart failure with preserved ejection fraction: an analysis of the I-Preserve study. Eur J Heart Fail. 2015;17(8):809–17.CrossRef
40.
Januzzi JL Jr, Butler J, Zannad F, Filippatos G, Ferreira JP, Pocock SJ, Sattar N, Verma S, Vedin O, Iwata T, Brueckmann M, Packer M, Anker SD, EMPEROR-Preserved Trial Study Group. Prognostic implications of N-Terminal Pro-B-type natriuretic peptide and high-sensitivity cardiac troponin T in EMPEROR-preserved. JACC Heart Fail. 2022;10(7):512–24.PubMedCrossRef
41.
Tanase DM, Radu S, Al Shurbaji S, et al. Natriuretic peptides in heart failure with preserved left ventricular ejection fraction: from molecular evidences to clinical implications. Int J Mol Sci. 2019;20(11):2629.PubMedPubMedCentralCrossRef
42.
Verbrugge FH, Omote K, Reddy YNV, Sorimachi H, Obokata M, Borlaug BA. Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J. 2022;43(20):1941–51.PubMedPubMedCentralCrossRef
43.
Messerli FH, Rimoldi SF, Bangalore S. The transition from hypertension to heart failure: contemporary update. JACC Heart Fail. 2017;5(8):543–51.PubMedCrossRef
44.
Inciardi RM, Galderisi M, Nistri S, Santoro C, Cicoira M, Rossi A. Echocardiographic advances in hypertrophic cardiomyopathy: three-dimensional and strain imaging echocardiography. Echocardiography. 2018;35(5):716–26.PubMedCrossRef
45.
Erma A, Meris A, Skali H, et al. Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) Echocardiographic Study. JACC Cardiovasc Imaging. 2008;1(5):582–91.CrossRef
46.
Mancusi C, Lembo M, Manzi MV, Basile C, Fucile I, Morisco C. From structural to functional hypertension mediated target organ damage—a long way to heart failure with preserved ejection fraction. J Clin Med. 2022;11(18):5377.PubMedPubMedCentralCrossRef
47.
Zile MR, Gottdiener JS, Hetzel SJ, et al. Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction. Circulation. 2011;124(23):2491–501.PubMedCrossRef
48.
Tadic M, Cuspidi C, Marwick TH. Phenotyping the hypertensive heart. Eur Heart J. 2022;43(38):3794–810.PubMedCrossRef
49.
Guide, Nagueh SF. Diastology: 2020—a practical. Echocardiography. 2020;37(11):1919–25.CrossRef
50.
Arnone MI, Sforza A, Carlino MV, Guarino M, Candido R, Bertolone D, Fucile I, De Luca N, Mancusi C. Assessment of E/A ratio helps emergency clinicians in the management of patients with acute dyspnea. Intern Emerg Med. 2023;18:1823–30.PubMedPubMedCentralCrossRef
51.
Galderisi M, Rapacciuolo A, Esposito R, et al. Site-dependency of the E/e’ ratio in predicting invasive left ventricular filling pressure in patients with suspected or ascertained coronary artery disease. Eur Heart J Cardiovasc Imaging. 2013;14(6):555–61.PubMedCrossRef
52.
Carlino MV, Paladino F, Sforza A, Serra C, Liccardi F, de Simone G, Mancusi C. Assessment of left atrial size in addition to focused cardiopulmonary ultrasound improves diagnostic accuracy of acute heart failure in the Emergency Department. Echocardiography. 2018;35(6):785–91.PubMedCrossRef
53.
Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277–314.PubMedCrossRef
54.
Sorrentino R, Esposito R, Santoro C, et al. Practical impact of new diastolic recommendations on noninvasive estimation of left ventricular diastolic function and filling pressures. J Am Soc Echocardiogr. 2020;33(2):171–81.PubMedCrossRef
55.
Schiano-Lomoriello V, Santoro C, de Simone G, Trimarco B, Galderisi M. Diastolic bicycle stress echocardiography: normal reference values in a middle age population. Int J Cardiol. 2015;91:181–3.CrossRef
56.
Contaldi C, Imbriaco M, Alcidi G, et al. Assessment of the relationships between left ventricular filling pressures and longitudinal dysfunction with myocardial fibrosis in uncomplicated hypertensive patients. Int J Cardiol. 2016;202:84–6.PubMedCrossRef
57.
Kraigher-Krainer E, Shah AM, Gupta DK, et al. Impaired systolic function by strain imaging in heart failure with preserved ejection fraction. J Am Coll Cardiol. 2014;63(5):447–56.PubMedCrossRef
58.
Pastore MC, Mandoli GE, Aboumarie HS, et al. Basic and advanced echocardiography in advanced heart failure: an overview. Heart Fail Rev. 2020;25(6):937–48.PubMedCrossRef
59.
Morris DA, Ma XX, Belyavskiy E, et al. Left ventricular longitudinal systolic function analysed by 2D speckle-tracking echocardiography in heart failure with preserved ejection fraction: a meta-analysis. Open Heart. 2017;4(2): e000630.PubMedPubMedCentralCrossRef
60.
D’Andrea A, Radmilovic J, Ballo P, et al. Left ventricular hypertrophy or storage disease? The incremental value of speckle tracking strain bull’s-eye. Echocardiography. 2017;34(5):746–59.PubMedCrossRef
61.
Galderisi M, Santoro C, Esposito R. Left atrial function and dyssynchrony: main characters and not actor appearances in heart failure with preserved ejection fraction. Int J Cardiol. 2018;257:222–3.PubMedCrossRef
62.
Lisi M, Mandoli GE, Cameli M, et al. Left atrial strain by speckle tracking predicts atrial fibrosis in patients undergoing heart transplantation. Eur Heart J Cardiovasc Imaging. 2022;23(6):829–35.PubMedCrossRef
63.
Cameli M, Sparla S, Losito M, et al. Correlation of left atrial strain and Doppler measurements with invasive measurement of left ventricular end-diastolic pressure in patients stratified for different values of ejection fraction. Echocardiography. 2016;33(3):398–405.PubMedCrossRef
64.
Inoue K, Khan FH, Remme EW, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021;23(1):61–70.PubMedPubMedCentralCrossRef
65.
Obokata M, Negishi K, Kurosawa K, et al. Incremental diagnostic value of la strain with leg lifts in heart failure with preserved ejection fraction. JACC Cardiovasc Imaging. 2013;6(7):749–58.PubMedCrossRef
66.
Cioffi G, Battiston R, Mancusi C, Di Lenarda A, Faganello G, Aurigemma GP, Tarantini L, Pulignano G, Cioffi V, de Simone G. Prognostic stratification of clinically stable patients with heart failure by echocardiographic pressure/volume loop model. J Am Soc Echocardiogr. 2023;36(7):746–59.PubMedCrossRef
67.
Capone F, Sotomayor-Flores C, Bode D, Wang R, Rodolico D, Strocchi S, Schiattarella GG. Cardiac metabolism in HFpEF: from fuel to signalling. Cardiovasc Res. 2023;118(18):3556–75.PubMedCrossRef
68.
Takei Y, Tomiyama H, Higashi Y, Yamashina A, Chikamori T. Association between endothelial dysfunction and left ventricular diastolic stiffness—subanalysis of the flow-mediated dilation Japan (FMD-J) Study. Circ J. 2023;87(9):1203–11.PubMedCrossRef
69.
Ali D, Tran P, Ennis S, Powell R, McGuire S, McGregor G, Kimani PK, Weickert MO, Miller MA, Cappuccio FP, Banerjee P. Rising arterial stiffness with accumulating comorbidities associates with heart failure with preserved ejection fraction. ESC Heart Fail. 2023;10(4):2487–98.PubMedPubMedCentralCrossRef
70.
Gargani L, Girerd N, Platz E, Pellicori P, Stankovic I, Palazzuoli A, Pivetta E, Miglioranza MH, Soliman-Aboumarie H, Agricola E, Volpicelli G, Price S, Donal E, Cosyns B, Neskovic AN. Lung ultrasound in acute and chronic heart failure. A Clinical Consensus Statement of the European Association of Cardiovascular Imaging (EACVI). Eur Heart J Cardiovasc Imaging. 2023;24:jead169.CrossRef
71.
Mancusi C, Serra C, Muiesan ML, Cogliati C. Lung ultrasound national report (LUNARE PROJECT) by the Italian Society of Internal Medicine (SIMI). Intern Emerg Med. 2023;18(2):685–8.PubMedCrossRef
72.
Demi L, Wolfram F, Klersy C, et al. New international guidelines and consensus on the use of lung ultrasound. J Ultrasound Med. 2023;42(2):309–44.PubMedCrossRef
73.
Sforza A, Mancusi C, Carlino MV, Buonauro A, Barozzi M, Romano G, Serra S, de Simone G. Diagnostic performance of multi-organ ultrasound with pocket-sized device in the management of acute dyspnea. Cardiovasc Ultrasound. 2017;15(1):16.PubMedPubMedCentralCrossRef
74.
Sforza A, Carlino MV, Albano G, Arnone MI, De Stefano G, D’Amato A, De Pisapia F, De Simone G, Mancusi C. A challenging diagnosis of dyspnea: a case report of contralateral reexpansion pulmonary edema. Monaldi Arch Chest Dis. 2018;88(1):900.PubMedCrossRef
75.
Maw AM, Hassanin A, Ho PM, et al. Diagnostic accuracy of point-of-care lung ultrasonography and chest radiography in adults with symptoms suggestive of acute decompensated heart failure: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(3): e190703.PubMedPubMedCentralCrossRef
76.
Cogliati C, Ceriani E, Gambassi G, et al. Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: the Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF-DRY-OFF STUDY. Eur J Intern Med. 2022;97:69–77.PubMedCrossRef
77.
Gargani L, Pugliese NR, Frassi F, et al. Prognostic value of lung ultrasound in patients hospitalized for heart disease irrespective of symptoms and ejection fraction. ESC Heart Fail. 2021;8(4):2660–9.PubMedPubMedCentralCrossRef
78.
Kagami K, Obokata M, Harada T, et al. Incremental diagnostic value of post-exercise lung congestion in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging. 2023;24(5):553–61.PubMedCrossRef
79.
Reddy YNV, Obokata M, Wiley B, et al. The haemodynamic basis of lung congestion during exercise in heart failure with preserved ejection fraction. Eur Heart J. 2019;40(45):3721–30.PubMedPubMedCentralCrossRef
80.
Mancusi C, Carlino MV, Sforza A. Point-of-care ultrasound with pocket-size devices in emergency department. Echocardiography. 2019;36(9):1755–64.PubMedCrossRef
81.
Sforza A, Carlino MV, Guarino M, et al. Anterior vs lateral symmetric interstitial syndrome in the diagnosis of acute heart failure. Int J Cardiol. 2019;280:130–2.PubMedCrossRef
82.
Guazzi M, Wilhelm M, Halle M, et al. Exercise testing in heart failure with preserved ejection fraction: an appraisal through diagnosis, pathophysiology and therapy—a clinical consensus statement of the Heart Failure Association and European Association of Preventive Cardiology. Eur J Heart Fail. 2022;24(8):1327–45.PubMedCrossRef
83.
Agostoni P, Dumitrescu D. How to perform and report a cardiopulmonary exercise test in patients with chronic heart failure. Int J Cardiol. 2019;288:107–13.PubMedCrossRef
84.
Reddy YNV, Olson TP, Obokata M, Melenovsky V, Borlaug BA. Hemodynamic correlates and diagnostic role of cardiopulmonary exercise testing in heart failure with preserved ejection fraction. JACC Heart Fail. 2018;6(8):665–75.PubMedPubMedCentralCrossRef
85.
Nayor M, Houstis NE, Namasivayam M, et al. Impaired exercise tolerance in heart failure with preserved ejection fraction: quantification of multiorgan system reserve capacity. JACC Heart Fail. 2020;8(8):605–17.PubMedPubMedCentralCrossRef
86.
Corrà U, Agostoni PG, Anker SD, et al. Role of cardiopulmonary exercise testing in clinical stratification in heart failure. A position paper from the Committee on Exercise Physiology and Training of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2018;20(1):3–15.PubMedCrossRef
87.
Klaassen SHC, Liu LCY, Hummel YM, et al. Clinical and hemodynamic correlates and prognostic value of VE/VCO2 slope in patients with heart failure with preserved ejection fraction and pulmonary hypertension. J Card Fail. 2017;23(11):777–82.PubMedCrossRef
88.
Alenezi F, Covington TA, Mukherjee M, Mathai SC, Yu PB, Rajagopal S. Novel approaches to imaging the pulmonary vasculature and right heart. Circ Res. 2022;130(9):1445–65.PubMedPubMedCentralCrossRef
89.
Del Punta L, De Biase N, Balletti A, et al. Arterial hypertension and cardiopulmonary function: the value of a combined cardiopulmonary and echocardiography stress test. High Blood Press Cardiovasc Prev. 2022;29(2):145–54.PubMedPubMedCentralCrossRef
90.
Reddy YNV, Kaye DM, Handoko ML, et al. Diagnosis of heart failure with preserved ejection fraction among patients with unexplained dyspnea. JAMA Cardiol. 2022;7(9):891–9.PubMedPubMedCentralCrossRef
91.
Borlaug BA, Sharma K, Shah SJ, Ho JE. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol. 2023;81(18):1810–34.PubMedCrossRef
92.
Kittleson MM, Panjrath GS, Amancherla K, Davis LL, Deswal A, Dixon DL, Januzzi JL Jr, Yancy CW. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81(18):1835–78.PubMedCrossRef
93.
Borlaug BA, Nishimura RA, Sorajja P, Lam CS, Redfield MM. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail. 2010;3(5):588–95.PubMedPubMedCentralCrossRef
94.
Simonneau G, Montani D, Celermajer DS, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019;53(1):1801913.PubMedPubMedCentralCrossRef
95.
96.
Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43(38):3618–731.PubMedCrossRef
97.
Nair N. Invasive hemodynamics in heart failure with preserved ejection fraction: importance of detecting pulmonary vascular remodeling and right heart function. Heart Fail Clin. 2021;17(3):415–22.PubMedCrossRef
98.
Bilak JM, Alam U, Miller CA, McCann GP, Arnold JR, Kanagala P. Microvascular dysfunction in heart failure with preserved ejection fraction: pathophysiology, assessment prevalence and prognosis. Card Fail Rev. 2022;8: e24.PubMedPubMedCentralCrossRef
99.
Prasad SB, Holland DJ, Atherton JJ. Diastolic stress echocardiography: from basic principles to clinical applications. Heart. 2018;104(21):1739–48.PubMedCrossRef
100.
Hsu S, Fang JC, Borlaug BA. Hemodynamics for the heart failure clinician: a state-of-the-art review. J Card Fail. 2022;28(1):133–48.PubMedCrossRef
101.
102.
Eisman AS, Shah RV, Dhakal BP, et al. Pulmonary capillary wedge pressure patterns during exercise predict exercise capacity and incident heart failure. Circ Heart Fail. 2018;11(5): e004750.PubMedPubMedCentralCrossRef
103.
Pandey A, Khera R, Park B, et al. Relative impairments in hemodynamic exercise reserve parameters in heart failure with preserved ejection fraction: a study-level pooled analysis. JACC Heart Fail. 2018;6(2):117–26.PubMedPubMedCentralCrossRef
104.
Obokata M, Olson TP, Reddy YNV, Melenovsky V, Kane GC, Borlaug BA. Haemodynamics, dyspnoea, and pulmonary reserve in heart failure with preserved ejection fraction. Eur Heart J. 2018;39(30):2810–21.PubMedPubMedCentralCrossRef
105.
Dorfs S, Zeh W, Hochholzer W, et al. Pulmonary capillary wedge pressure during exercise and long-term mortality in patients with suspected heart failure with preserved ejection fraction. Eur Heart J. 2014;35(44):3103–12.PubMedCrossRef
106.
107.
Wolsk E, Bakkestrøm R, Thomsen JH, et al. The influence of age on hemodynamic parameters during rest and exercise in healthy individuals. JACC Heart Fail. 2017;5(5):337–46.PubMedCrossRef
108.
Naeije R, Vanderpool R, Dhakal BP, et al. Exercise-induced pulmonary hypertension: physiological basis and methodological concerns. Am J Respir Crit Care Med. 2013;187(6):576–83.PubMedPubMedCentralCrossRef
109.
Ho JE, Zern EK, Wooster L, et al. Differential clinical profiles, exercise responses, and outcomes associated with existing HFpEF definitions. Circulation. 2019;140(5):353–65.PubMedPubMedCentralCrossRef
110.
Parasuraman SK, Loudon BL, Lowery C, et al. Diastolic ventricular interaction in heart failure with preserved ejection fraction. J Am Heart Assoc. 2019;8(7): e010114.PubMedPubMedCentralCrossRef
111.
Gorter TM, Obokata M, Reddy YNV, Melenovsky V, Borlaug BA. Exercise unmasks distinct pathophysiologic features in heart failure with preserved ejection fraction and pulmonary vascular disease. Eur Heart J. 2018;39(30):2825–35.PubMedPubMedCentralCrossRef
112.
Lewis GD, Bossone E, Naeije R, et al. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation. 2013;128(13):1470–9.PubMedCrossRef
113.
Dhakal BP, Malhotra R, Murphy RM, et al. Mechanisms of exercise intolerance in heart failure with preserved ejection fraction: the role of abnormal peripheral oxygen extraction. Circ Heart Fail. 2015;8(2):286–94.PubMedCrossRef
114.
D’Alto M, Romeo E, Argiento P, et al. Clinical relevance of fluid challenge in patients evaluated for pulmonary hypertension. Chest. 2017;151(1):119–26.PubMedCrossRef
115.
Andersen MJ, Olson TP, Melenovsky V, Kane GC, Borlaug BA. Differential hemodynamic effects of exercise and volume expansion in people with and without heart failure. Circ Heart Fail. 2015;8(1):41–8.PubMedCrossRef
116.
van de Bovenkamp AA, Wijkstra N, Oosterveer FPT, et al. The value of passive leg raise during right heart catheterization in diagnosing heart failure with preserved ejection fraction. Circ Heart Fail. 2022;15(4): e008935.PubMedPubMedCentral
117.
Hummel YM, Liu LCY, Lam CSP, Fonseca-Munoz DF, Damman K, Rienstra M, van der Meer P, Rosenkranz S, van Veldhuisen DJ, Voors AA, Hoendermis ES. Echocardiographic estimation of left ventricular and pulmonary pressures in patients with heart failure and preserved ejection fraction: a study utilizing simultaneous echocardiography and invasive measurements. Eur J Heart Fail. 2017;19(12):1651–60.PubMedCrossRef
118.
Reddy YNV, Kaye DM, Handoko ML, van de Bovenkamp AA, Tedford RJ, Keck C, Andersen MJ, Sharma K, Trivedi RK, Carter RE, Obokata M, Verbrugge FH, Redfield MM, Borlaug BA. Diagnosis of heart failure with preserved ejection fraction among patients with unexplained dyspnea. JAMA Cardiol. 2022;7(9):891–9.PubMedPubMedCentralCrossRef
119.
van Heerebeek L, Hamdani N, Handoko ML, Falcao-Pires I, Musters RJ, Kupreishvili K, Ijsselmuiden AJ, Schalkwijk CG, Bronzwaer JG, Diamant M, Borbély A, van der Velden J, Stienen GJ, Laarman GJ, Niessen HW, Paulus WJ. Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation. 2008;117(1):43–51.PubMedCrossRef
120.
Westermann D, Lindner D, Kasner M, Zietsch C, Savvatis K, Escher F, von Schlippenbach J, Skurk C, Steendijk P, Riad A, Poller W, Schultheiss HP, Tschöpe C. Cardiac inflammation contributes to changes in the extracellular matrix in patients with heart failure and normal ejection fraction. Circ Heart Fail. 2011;4(1):44–52.PubMedCrossRef
121.
Hahn VS, Yanek LR, Vaishnav J, Ying W, Vaidya D, Lee YZJ, Riley SJ, Subramanya V, Brown EE, Hopkins CD, Ononogbu S, Perzel Mandell K, Halushka MK, Steenbergen C Jr, Rosenberg AZ, Tedford RJ, Judge DP, Shah SJ, Russell SD, Kass DA, Sharma K. Endomyocardial biopsy characterization of heart failure with preserved ejection fraction and prevalence of cardiac amyloidosis. JACC Heart Fail. 2020;8(9):712–24.PubMedPubMedCentralCrossRef
122.
Mohammed SF, Hussain S, Mirzoyev SA, Edwards WD, Maleszewski JJ, Redfield MM. Coronary microvascular rarefaction and myocardial fibrosis in heart failure with preserved ejection fraction. Circulation. 2015;131(6):550–9.PubMedCrossRef
123.
Peters AE, Tromp J, Shah SJ, Lam CSP, Lewis GD, Borlaug BA, Sharma K, Pandey A, Sweitzer NK, Kitzman DW, Mentz RJ. Phenomapping in heart failure with preserved ejection fraction: insights, limitations, and future directions. Cardiovasc Res. 2023;118(18):3403–15 (Erratum in: Cardiovasc Res. 2023 Jan 21).PubMedCrossRef
124.
Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069–84.PubMedCrossRef
125.
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221–32.PubMedCrossRef
126.
Sevre K, Rist A, Wachtell K, Devereux RB, Aurigemma GP, Smiseth OA, Kjeldsen SE, Julius S, Pitt B, Burnier M, Kreutz R, Oparil S, Mancia G, Zannad F. What is the current best drug treatment for hypertensive heart failure with preserved ejection fraction? Review of the totality of evidence. Am J Hypertens. 2023;37:hpad073.
Metadata
Title
Novel Strategies in Diagnosing Heart Failure with Preserved Ejection Fraction: A Comprehensive Literature Review
Authors
Costantino Mancusi
Christian Basile
Carmen Spaccarotella
Giuseppe Gargiulo
Ilaria Fucile
Stefania Paolillo
Paola Gargiulo
Ciro Santoro
Lina Manzi
Federica Marzano
Pasquale Ambrosino
Nicola De Luca
Giovanni Esposito
Publication date
15-03-2024
Publisher
Springer International Publishing
Published in
High Blood Pressure & Cardiovascular Prevention / Issue 2/2024
Print ISSN: 1120-9879
Electronic ISSN: 1179-1985
DOI
https://doi.org/10.1007/s40292-024-00629-1

Other articles of this Issue 2/2024

High Blood Pressure & Cardiovascular Prevention 2/2024 Go to the issue

Original article

Prevalence and Burden of Carotid and Femoral Atherosclerosis in Subjects Without Known Cardiovascular Disease in a Large Community Hospital in South-America

Letter to the Editor

Nursing Counseling in Patients Recently Admitted in Cardiac Rehabilitation Unit: A Pilot Study-Brief Letter for Publication

Original article

Association Between Elevated Body Mass Index and Cardiac Organ Damage in Children and Adolescents: Evidence and Mechanisms

Review article

Effect of Coenzyme Q10 Supplementation on Vascular Endothelial Function: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Short Communication

Measuring Costs of Cardiovascular Disease Prevention for Patients with Familial Hypercholesterolemia in Administrative Claims Data

Original article

Clinical Implications of Estimating Glomerular Filtration Rate with Different Equations in Heart Failure Patients with Preserved Ejection Fraction