ALAPIO CME MEETING - DECEMBER 12, 2018 SPICE AFFAIR, BEVERLY HILLS

Heart Failure with Preserved Ejection Fraction- HFpEF

Michelle Kittleson MD, PhD

In the past Diastolic Congestive Heart Failure was the term that is now replaced by HeFpEF. This is different from the one with reduced ejection fraction HeFrEF. In HeFpEF, an ejection fraction of more than 40% is maintained.

An echocardiogram is the simple procedure for diagnosis.

HeFpEF has been on the rise since 1986, and in the period of 2002-2010, it has become a major problem.

There is now an equal distribution of HeFpEF and HeFrEF, and the mortality rates are equal too.

HeFpEF is not just a disease of the heart but is a whole body disease.

It is, “the rheumatology of cardiology.”

It causes a stiffening of the heart and the response to therapy is limited.

Diuretics, the mainstay of HeFrEF therapy, is of little use. Other modalities that are ineffective are:

isordil/hydralizine, Irbesartan, Perindopril, Statins, Digoxin, Sildanafil, Imdur, Ivabradine, and Nvibolol.


The following have shown promise in therapy:

Spironolactone, Candesartan, calorie reduction in food intake, Exercise training,

Studies are being performed on stem cell therapy and using extra cellular heart modification and the use of Torsemide.


PLEASE SEE THE FOLLOWING LINK FOR AN ENLIGHTENING ARTICLE ON THIS SUBJECT


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056204/