2026/06/22 by Rosita Zakeri, Adam Nabeebaccus · 1 voice
Medicine · #Cardiovascular Function and Risk Factors #Electrolyte and hormonal disorders #Heart Failure Treatment and Management
paper · doi:10.1016/j.clinme.2026.100608
openalex publication_date 2026/06/22 · openalex created_date 2026/06/23 · openalex updated_date 2026/07/27
Heart failure (HF) with preserved ejection fraction (HFpEF) is becoming the dominant HF phenotype in clinical practice, reflecting population ageing and increasing cardiometabolic disease. Contemporary HFpEF is recognised as a complex, systemic syndrome with heterogeneous pathophysiology and substantial morbidity. It remains underdiagnosed, with many patients detected only during hospitalisation. Diagnosis requires a high index of suspicion and a structured approach integrating clinical assessment, natriuretic peptides and echocardiography to demonstrate elevated left ventricular filling pressures and exclude alternative diagnoses. Recent randomised trials have demonstrated that sodium-glucose cotransporter-2 (SGLT2) inhibitors and non-steroidal mineralocorticoid receptor antagonists reduce HF hospitalisations and improve quality of life. Additional strategies, including obesity-targeted therapies, support phenotype-directed management, alongside core strategies of congestion relief, comorbidity optimisation, and multidisciplinary care. Early recognition and timely initiation of evidence-based therapy are essential to improve outcomes for this population. This review provides a practical, evidence-based framework for the contemporary diagnosis and management of HFpEF.