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Patient phenotype profiling in heart failure with preserved ejection fraction to guide therapeutic decision making. A scientific statement of the Heart Failure Association,the European Heart Rhythm Association of the European Society of Cardiology,and the European Society of Hypertension |
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| Authors: | Stefan D. Anker Muhammad Shariq Usman Markus S. Anker Javed Butler Michael Böhm William T. Abraham Marianna Adamo Vijay K. Chopra Mariantonietta Cicoira Francesco Cosentino Gerasimos Filippatos Ewa A. Jankowska Lars H. Lund Brenda Moura Wilfried Mullens Burkert Pieske Piotr Ponikowski Jose R. Gonzalez-Juanatey Amina Rakisheva Gianluigi Savarese Petar Seferovic John R. Teerlink Carsten Tschöpe Maurizio Volterrani Stephan von Haehling Jian Zhang Yuhui Zhang Johann Bauersachs Ulf Landmesser Shelley Zieroth Konstantinos Tsioufis Antoni Bayes-Genis Ovidiu Chioncel Felicita Andreotti Enrico Agabiti-Rosei Jose L. Merino Marco Metra Andrew J.S. Coats Giuseppe M.C. Rosano |
| Affiliation: | 1. Department of Cardiology, Deutsches Herzzentrum der Charité (Campus CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany;2. Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA;3. Deutsches Herzzentrum der Charité, Klinik fär Kardiologie, Angiologie und Intensivmedizin (Campus CBF), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany;4. Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA Baylor Scott and White Research Institute, Dallas, TX, USA;5. Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany;6. Ohio State University Wexner Medical Center, Columbus, OH, USA;7. Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy;8. Max Superspeciality Hospital, New Delhi, India;9. Division of Cardiology, Magalini Hospital, Verona, Italy;10. Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden;11. National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;12. Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland;13. Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal;14. Serviço de Cardiologia, Hospital das Forças Armadas-Pólo do Porto, Porto, Portugal;15. Department of Cardiology, Ziekenhuis Oost Limburg, Genk and Faculty of Medicine and Life Sciences, University Hasselt, Belgium;16. Berlin-Brandenburgische Gesellschaft für Herz-Kreislauferkrankungen (BBGK), Berlin, Germany;17. Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland Cardiology Department, Wroclaw Medical University, Wroclaw, Poland;18. Cardiology Department, Hospital Clínico Universitario, Santiago de Compostela, IDIS, CIBERCV, Santiago de Compostela, Spain;19. Department of Cardiology, Scientific Institution of Cardiology and Internal Diseases, Almaty, Kazakhstan;20. Department Faculty of Medicine, University of Belgrade, Belgrade & Serbian Academy of Sciences and Arts, Belgrade, Serbia;21. Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, CA, USA;22. Department of Cardiology, Deutsches Herzzentrum der Charité (Campus CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany Department of Cardiology, Angiology and Intensive Care Medicine (CVK), Charité Universitätsmedizin, Berlin, Germany;23. Cardio-Pulmonary Department, San Raffaele Open University of Rome;24. Exercise Science and Medicine, IRCCS San Raffaele – Rome, Italy;25. Department of Cardiology, University Medcine Göttingen, Göttingen, Germany;26. Fuwai Hospital Chinese Academic of Medical Science, Beijing, China;27. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany;28. Deutsches Herzzentrum der Charité, Klinik fär Kardiologie, Angiologie und Intensivmedizin (Campus CBF), Berlin Institute of Health Center for Regenerative Therapies (BCRT), and German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany Berlin Institute of Health at Charité, Berlin, Germany;29. Section of Cardiology, Max Rady College of Medicine, University of Manitoba Winnipeg, Winnipeg, Manitoba, Canada;30. 1st Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece;31. Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, CIBERCV, Barcelona, Spain;32. Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, University of Medicine Carol Davila, Bucharest, Romania;33. Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy Catholic University Medical School, Rome, Italy;34. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy;35. Department of Cardiology, La Paz University Hospital, IdiPaz, Universidad Autonoma, Madrid, Spain;36. Heart Research Institute, Newtown, NSW, Australia |
| Abstract: | Heart failure with preserved ejection fraction (HFpEF) represents a highly heterogeneous clinical syndrome affected in its development and progression by many comorbidities. The left ventricular diastolic dysfunction may be a manifestation of various combinations of cardiovascular, metabolic, pulmonary, renal, and geriatric conditions. Thus, in addition to treatment with sodium–glucose cotransporter 2 inhibitors in all patients, the most effective method of improving clinical outcomes may be therapy tailored to each patient's clinical profile. To better outline a phenotype-based approach for the treatment of HFpEF, in this joint position paper, the Heart Failure Association of the European Society of Cardiology, the European Heart Rhythm Association and the European Hypertension Society, have developed an algorithm to identify the most common HFpEF phenotypes and identify the evidence-based treatment strategy for each, while taking into account the complexities of multiple comorbidities and polypharmacy. |
| Keywords: | Heart failure Heart failure with preserved ejection fraction Phenotype |