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Distinct Profiles and New Pharmacological Targets for Heart Failure with Preserved Ejection Fraction

Authors :
Alberto Palazzuoli
Paolo Severino
Andrea D’Amato
Vincenzo Myftari
Lucia Tricarico
Michele Correale
Giuseppe Dattilo
Francesco Fioretti
Savina Nodari
Source :
Reviews in Cardiovascular Medicine, Vol 25, Iss 7, p 270 (2024)
Publication Year :
2024
Publisher :
IMR Press, 2024.

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) is a multifactorial condition with a variety of pathophysiological causes and morphological manifestations. The inclusion criteria and patient classification have become overly simplistic due to the customary differentiation regarding the ejection fraction (EF) cutoff. EF is considered a measure of systolic function; nevertheless, it only represents a portion of the true contractile state and has been shown to have certain limits due to methodological and hemodynamic irregularities. Methods: As a result, broader randomized clinical trials have yet to incorporate the most recent criteria for HFpEF diagnosis, leading to a lack of data consistency and confusion in interpreting the results. The primary variations between the bigger clinical trials published in this context concerning patient selection and echocardiographic characteristics were analyzed. For all these reasons, we aim to clarify the main features and clinical impact of HFpEF in a study combining imaging, bio-humoral analysis, and clinical history to identify the specific subgroups that respond better to tailored treatment. Results: Disparate clinical characteristics and a lack of uniform diagnostic standards may cause suboptimal therapeutic feedback. To optimize treatment, we suggest shifting the paradigm from the straightforward EF measurement to a more comprehensive model that considers additional information, such as structural traits, related disorders, and biological and environmental data. Therefore, by evaluating certain echocardiographic and clinical factors, a stepwise diagnostic procedure may be useful in identifying patients at high risk, subjects with early HFpEF, and those with evident HFpEF. Conclusions: The present assessment underscores the significance of the precision medicine approach in guaranteeing optimal patient outcomes by providing the best care according to each distinct profile.

Details

Language :
English
ISSN :
15306550
Volume :
25
Issue :
7
Database :
Directory of Open Access Journals
Journal :
Reviews in Cardiovascular Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.f4e3a46abb148f0bfa58364f205cdb0
Document Type :
article
Full Text :
https://doi.org/10.31083/j.rcm2507270