Congestive heart failure with preserved EF pharmacotherapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
HFpEF pharmacotherapy
Treatment for HFpEF is based on underlying associated conditions. These measure are mainly focused on:
- Hypertension Control[1]
- Control of volume overload[2][3]
- Atrial fibrillation rate control[4]
- Appropriate diet and exercise[5]
- Weight control[5]
- Control of co-morbid conditions, such as diabetes, anemia, hyperlipidemia, sleep apnea and COPD.[6]
Medications
- Spironolactone
- May lead to improvement in diastolic function and hypertrophy but not in clinical outcomes.[7]
References
- ↑ Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, Stoyanovsky V, Antikainen RL, Nikitin Y, Anderson C, Belhani A, Forette F, Rajkumar C, Thijs L, Banya W, Bulpitt CJ (2008). "Treatment of hypertension in patients 80 years of age or older". N. Engl. J. Med. 358 (18): 1887–98. doi:10.1056/NEJMoa0801369. PMID 18378519.
- ↑ Takei M, Kohsaka S, Shiraishi Y, Goda A, Izumi Y, Yagawa M, Mizuno A, Sawano M, Inohara T, Kohno T, Fukuda K, Yoshikawa T (2015). "Effect of estimated plasma volume reduction on renal function for acute heart failure differs between patients with preserved and reduced ejection fraction". Circ Heart Fail. 8 (3): 527–32. doi:10.1161/CIRCHEARTFAILURE.114.001734. PMID 25737498.
- ↑ Felker GM, Lee KL, Bull DA, Redfield MM, Stevenson LW, Goldsmith SR, LeWinter MM, Deswal A, Rouleau JL, Ofili EO, Anstrom KJ, Hernandez AF, McNulty SE, Velazquez EJ, Kfoury AG, Chen HH, Givertz MM, Semigran MJ, Bart BA, Mascette AM, Braunwald E, O'Connor CM (2011). "Diuretic strategies in patients with acute decompensated heart failure". N. Engl. J. Med. 364 (9): 797–805. doi:10.1056/NEJMoa1005419. PMC 3412356. PMID 21366472.
- ↑ Zakeri R, Chamberlain AM, Roger VL, Redfield MM (2013). "Temporal relationship and prognostic significance of atrial fibrillation in heart failure patients with preserved ejection fraction: a community-based study". Circulation. 128 (10): 1085–93. doi:10.1161/CIRCULATIONAHA.113.001475. PMC 3910441. PMID 23908348.
- ↑ 5.0 5.1 Haass M, Kitzman DW, Anand IS, Miller A, Zile MR, Massie BM, Carson PE (2011). "Body mass index and adverse cardiovascular outcomes in heart failure patients with preserved ejection fraction: results from the Irbesartan in Heart Failure with Preserved Ejection Fraction (I-PRESERVE) trial". Circ Heart Fail. 4 (3): 324–31. doi:10.1161/CIRCHEARTFAILURE.110.959890. PMC 3100162. PMID 21350053.
- ↑ Alehagen U, Benson L, Edner M, Dahlström U, Lund LH (2015). "Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of ≥50". Circ Heart Fail. 8 (5): 862–70. doi:10.1161/CIRCHEARTFAILURE.115.002143. PMID 26243795.
- ↑ Edelmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, Kamke W, Duvinage A, Stahrenberg R, Durstewitz K, Löffler M, Düngen HD, Tschöpe C, Herrmann-Lingen C, Halle M, Hasenfuss G, Gelbrich G, Pieske B (2013). "Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial". JAMA. 309 (8): 781–91. doi:10.1001/jama.2013.905. PMID 23443441.