Diagnosing HFpEF: Can We Simplify It?


Dr Partho P Sengupta, USA    04 January 2018

  1. Current schemes for assessing DD and filling pressures have limitations.
  2. Contemporary HFpEF diagnosis should rely on clinical findings+echo, when in doubt use exercise echo, cardiac Cath.
  3. AI techniques may help automate and improve precision in noninvasive assessment of LV filling pressures.
  4. Novel screening tools are needed; wavelet transform EKG may be an attractive solution.

HFpEF: Treatment pearls

  1. Garden-variety HFpEF: Treat BP, DM, obesity, refer for clinical trial if AF, trial of cardioversion.
  2. CAD-HFpEF: Treat like HFrEF (BB, ACEI/ARB, revascularization).
  3. Right heart failure- HFpEF: Diuresis/ultrafiltration, digoxin.
  4. HCM-HFpEF: Verapamil, diltiazem, long-acting metoprolol.
  5. Valvular HFpEF: Treat valvular disease if possible.
  6. High output HFpEF: Treat underlying cause, diuretics/UF.

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