Treatment of Heart Failure With Preserved Ejection Fraction: Have We Been Pursuing the Wrong Paradigm?

June 2011
Mayo Clinic Proceedings;Jun2011, Vol. 86 Issue 6, p531
Academic Journal
Heart failure with preserved ejection fraction (HF-PELF) Is the clinical syndrome of heart failure associated with normal or near- normal systolic function. Because inhibition of the adrenergic and renin-anglotensin-aidosterone systems has been so effective in the treatment of systollc heart failure, these same therapies have been the subject of recent clinical trials of HF-PEF. in this review, we examine the current evidence about treatment of HF- PEF, with particular emphasis on reviewing the literature for large- scale randomized clinical studies. The lack of significant benefit with neuorhormonal antagonism in HF-PEF suggests that this condition might not involve neurohormonal activation as a critical pathophyslologic mechanism. Perhaps heart failure as we traditionally think of it Is the wrong paradigm to pursue as we try to understand this condition of volume overload known as HF-PEF.


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