Understanding heart failure with preserved ejection fraction

Heart failure is a clinical syndrome characterised by symptoms, which as described by the British Society for Heart Failure (BSH) ‘F word’ campaign, consist of: Fighting for breath; Fluid retention; and Fatigue.¹ It usually occurs as a result of a structural or functional cardiac issue. Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of all heart failure diagnoses² and is responsible for an increasing proportion of heart failure related hospital admissions.³ The demographics of HFpEF differ slightly from those with heart failure with reduced ejection fraction (HFrEF). People with HFpEF are likely to be older, more likely to be female and co-morbidities both cardiovascular and non-cardiovascular are more likely to be present.⁴ The management of HFpEF is distinct from HFrEF as there are no guideline recommended disease modifying therapies and so treatment intervention is instead focused upon comorbidity and symptom management.⁴ So, what does HFpEF mean in terms of a diagnosis, and what are the implications for patients and their families?