Heart Failure with Preserved Left Ventricular Ejection Fraction

S.M. Коzhukhov, О.M. Pаrkhomenko


Heart failure with preserved left ventricular ejection fraction (HF-PEF) is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank–Starling mechanism. Prognosis is almost as severe as for the heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is confirmed by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation or increased LV diastolic stiffness. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.


heart failure; diastolic function; ejection fraction


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