Heart failure and its complications are significant
causes of mortality and morbidity in most societies. Major
parts of the studies that constitute the base of modern treatment
of heart failure have been limited to the study of heart
failure associated with reduced left ventricular ejection fraction
(HFrEF). Only during the past 10–15 years, heart failure
associated with preserved left ventricular ejection fraction
(HFpEF) or primarily right-sided heart failure have come
more into focus as our understanding of the critical role of
other etiologies for the clinical syndrome of heart failure than
a reduced left ventricular (LV) ejection fraction has increased.
Furthermore, whilst the powerful prognostic role of a reduced
LV ejection fraction has long since been well validated, only
relatively recently it was realized that patients with heart
failure symptoms and preserved LVejection fraction also have
a substantially impaired prognosis. Previously, these patients
had often been dismissed as not having "real heart failure". In
parallel, it has become clear that diagnoses like hypertensive
heart disease, diabetic cardiomyopathy and heart failure associated
with atrial fibrillation, among others, can be understood as forms of HFpEF.
New York, 2013. Vol. 6, no 6, 523-533 p.