Heart Failure with Preserved Ejection Fraction: Management Guidelines (From Heart Failure Association of India, Endorsed by Association of Physicians of India)

J Assoc Physicians India. 2022 Aug;70(8):11-12. doi: 10.5005/japi-11001-0077.

Abstract

Heart failure with preserved ejection fraction (HFpEF) accounts for 15-20% of patients with heart failure (HF) in India. Diagnosis is by clinical features supported by biomarkers and echocardiography. Lifestyle modifications, control of risk factors to optimum levels, and treatment of comorbidities are essential in the management of HFpEF. Spironolactone and sacubitril-valsartan [angiotensin receptor neprilysin inhibitor (ARNI)] are beneficial in subsets of HFpEF, especially with lower range of ejection fraction (EF). Sodium-glucose co-transporter-2 inhibitors (SGLT2i)-empagliflozin and dapagliflozin and probably sotagliflozin are the only currently available drugs which have shown benefits in HFpEF, mostly by reducing hospitalizations. The benefit of SGLT2i is evident in both diabetic and nondiabetic subsets.

MeSH terms

  • Aminobutyrates
  • Angiotensin Receptor Antagonists / therapeutic use
  • Biphenyl Compounds
  • Drug Combinations
  • Heart Failure* / diagnosis
  • Heart Failure* / drug therapy
  • Humans
  • Physicians*
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • Stroke Volume
  • Tetrazoles / adverse effects

Substances

  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Biphenyl Compounds
  • Drug Combinations
  • Sodium-Glucose Transporter 2 Inhibitors
  • Tetrazoles
  • sacubitril