When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Heart failure with preserved ejection fraction

Last reviewed: 17 Aug 2025
Last updated: 08 Jan 2025

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • exertional dyspnea
Detalhes completos

Outros fatores diagnósticos

  • orthopnea
  • paroxysmal nocturnal dyspnea
  • abdominal fullness
  • rales
  • jugular venous distention
  • hepatojugular reflux
  • congestive hepatomegaly
  • lower extremity edema
  • laterally displaced apical impulse
  • gallop sounds
Detalhes completos

Fatores de risco

  • hypertension
  • atrial fibrillation (AF)
  • female sex
  • age >70 years
  • obesity
  • coronary artery disease (CAD)/ischemia
  • diabetes mellitus
  • chronic kidney disease (CKD)
  • dyslipidemia
  • exposure to cardiotoxic agents
  • metabolic syndrome or cardiovascular-kidney-metabolic (CKM) syndrome
  • myocardial and pericardial disorders
  • obstructive sleep apnea
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • serum electrolytes
  • renal function tests
  • liver enzymes
  • B-natriuretic peptide (BNP)/N-terminal prohormone B-natriuretic peptide (NT-proBNP)
  • CBC and iron studies
  • 12-lead ECG
  • blood glucose
  • thyroid function tests
  • blood lipids
  • CXR
  • transthoracic echocardiography
Detalhes completos

Investigações a serem consideradas

  • cardiac magnetic resonance (CMR) imaging
  • CT angiography
  • radionuclide ventriculography (MUGA scan)
  • stress testing
  • cardiopulmonary exercise testing (CPET)
  • cardiac catheterization and coronary angiography
Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Autores

Syed Wamique Yusuf, FACC, FRCPI

Professor of Medicine

Department of Cardiology

University of Texas MD Anderson Cancer Center

Houston

TX

Declarações

SWY declares that he has no competing interests.

Carl Zehner, MD

Assistant Professor of Medicine

Department of Cardiology

University of Texas MD Anderson Cancer Center

Houston

TX

Declarações

CZ declares that he has no competing interests.

Agradecimentos

Dr Syed Wamique Yusuf and Dr Carl Zehner would like to gratefully acknowledge Dr Gerald Carr-White, Dr Jessica Webb, Dr Gerard Aurigemma, Dr Lokesh Tejwani, Dr Marc E. Del Rosario, and Dr Kul Aggarwal, previous contributors to this topic.

Declarações

GCW has been reimbursed by Pfizer, AstraZeneca, Bayer, Medtronic, St Jude, and Sanofi for attending conferences. He has attended Advisory Boards for Medtronic, St Jude, Novartis, Shire, Sanofi, and Servier. JW has a joint working venture with BI for a community pharmacist post. GA, LT, MEDR, and KA declare that they have no competing interests.

Revisores

Edward Geltman, MD

Professor of Medicine

Cardiovascular Division

Washington University School of Medicine

St. Louis

MO

Declarações

EG has lectured for Novartis, Forest, Merck, and Pfizer.

Jerry Murphy, MB, BS, DM, FRCP

Consultant Cardiologist

Darlington Memorial Hospital

Darlington

UK

Раскрытие информации

Not disclosed.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Bozkurt B, Coats AJ, Tsutsui H, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. 2021 Mar 1;S1071-9164(21)00050-6.Полный текст  Аннотация

Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023 May 9;81(18):1835-78.Полный текст  Аннотация

Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2022 May 3;145(18):e895-1032.Полный текст  Аннотация

McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-726.Полный текст

McDonagh TA, Metra M, Adamo M, et al. 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023 Oct 1;44(37):3627-39.Полный текст

Borlaug BA, Sharma K, Shah SJ, et al. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol. 2023 May 9;81(18):1810-34. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Использование этого контента попадает под действие нашего заявления об отказе от ответственности