Author + information
- Received July 29, 2008
- Revision received December 2, 2008
- Accepted December 8, 2008
- Published online March 17, 2009.
- Micha T. Maeder, MD and
- David M. Kaye, MD, PhD* ()
- ↵*Reprint requests and correspondence:
Prof. David M. Kaye, Cardiology and Therapeutics Division, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, St Kilda Road, Central Melbourne 8008 VIC, Australia
It is estimated that approximately 50% of the heart failure population has a normal left ventricular ejection fraction, a complex broadly referred to as heart failure with normal left ventricular ejection fraction (HFNEF). While these patients have been considered in epidemiologic studies and clinical trials to represent a single pool of patients, limited more detailed studies indicate that HFNEF patients are a very heterogeneous group, with a number of key pathophysiologic mechanisms. This review summarizes and critically analyzes available data on the pathophysiology of HFNEF, placing it into context with a recently developed diagnostic algorithm. We evaluate the utility of commonly applied echocardiographic measures and biomarkers and integrate mechanistic observations into potential future therapeutic directions.
Dr. Maeder is supported by the Swiss National Science Foundation (grant PBZHB-121007, Zürich, Switzerland).
- Received July 29, 2008.
- Revision received December 2, 2008.
- Accepted December 8, 2008.
- American College of Cardiology Foundation