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Heart failure with preserved ejection fraction: fighting misconceptions for a new approach.
MedLine Citation:
PMID:  21789346     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Over the last decades, heart failure with preserved ejection fraction (HFpEF) has received less attention by the medical and scientific communities, which led to the emergence of a number of misconceptions concerning its characteristics, diagnostic and therapeutic approach. In recent years, new studies have changed the concepts traditionally associated with HFpEF, contributing to a new view towards this disease. This review is intended to discuss the latest evidence on HFpEF and to fight the main misconceptions associated with it in order to improve its diagnostic and therapeutic approach. Today we have several data showing that HFpEF is a condition that requires a different clinical approach from that used in systolic heart failure (SHF). HFpEF is no longer seen as a "benign" disease because it is associated with a poor prognosis and high prevalence. Its pathophysiology is complex and not fully clarified. In addition to diastolic dysfunction, we now know that other cardiac and extracardiac factors are also involved in its onset and progression. Using recent consensus guidelines we have objective criteria for its diagnosis, especially by using the new echocardiographic parameters for assessing diastolic function, including the E/e' ratio obtained by tissue Doppler. Finally, treatment of HFpEF remains unknown, because no therapeutic strategy has been shown to improve HFpEF prognosis. Thus, in this review we will also discuss the potentially new therapeutic targets for HFpEF.
Authors:
Ricardo Fontes-Carvalho; Adelino Leite-Moreira
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  96     ISSN:  1678-4170     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-7-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  -    
Other Details:
Languages:  SPA; ENG; POR     Pagination:  504-514     Citation Subset:  -    
Affiliation:
Serviço de Fisiologia, Faculdade de Medicina do Porto.
Vernacular Title:
Insuficiência cardíaca com fração de ejeção preservada: combater equívocos para uma nova abordagem.
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