Heart Failure With Low and Preserved Left Ventricular Ejection Fraction – are These Two Different Independent Diseases or One Disease, but at Different Stages of its Progression? How Does This Affect the Choice of Therapy and Its Effectiveness?
https://doi.org/10.18087/cardio.2023.10.n2553
Abstract
The article discusses the question of whether it is possible to conclude that any heart failure (HF), throughout the entire range of left ventricular ejection fractions (LVEF), is a single holistic disease, based on the “external” similarity of treatments for reduced (HFrEF) and preserved (HFpEF) LVEF, and that positioning HFpEF and HFrEF as separate independent diseases is not valid.
About the Authors
F. T. Ageev
Chazov National Medical Research Center of Cardiology
Russian Federation
Russian Federation
M.D., Prof., Chief Researcher,
Moscow
A. G. Ovchinnikov
Chazov National Medical Research Center of Cardiology; Evdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
Dr. Sci. (Med.), leading researcher,
Moscow
References
1. Ageev F.T., Ovchinnikov A.G. Diastolic heart failure: 20 years later. Сurrent issues of pathogenesis, diagnosis and treatment of heart failure with preserved LVEF. Kardiologiia. 2023;63(3): 3–12. DOI: 10.18087/cardio.2023.3.n2376
2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Journal of the American College of Cardiology. 2022;79(17):e263–421. DOI: 10.1016/j.jacc.2021.12.012
3. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2023;ehad195. [Epub ahead of print]. DOI: 10.1093/eurheartj/ehad195
4. Solomon SD, McMurray JJV, Claggett B, de Boer RA, DeMets D, Hernandez AF et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. New England Journal of Medicine. 2022;387(12):1089–98. DOI: 10.1056/NEJMoa2206286
5. Anker SD, Butler J, Filippatos G, Ferreira JP, Bocchi E, Böhm M et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. New England Journal of Medicine. 2021;385(16):1451–61. DOI: 10.1056/NEJMoa2107038
6. Packer M. Molecular, Cellular, and Clinical Evidence That Sodium‐ Glucose Cotransporter 2 Inhibitors Act as Neurohormonal Antagonists When Used for the Treatment of Chronic Heart Failure. Journal of the American Heart Association. 2020;9(16):e016270. DOI: 10.1161/JAHA.120.016270
7. Bosch A, Poglitsch M, Kannenkeril D, Kolwelter J, Striepe K, Ott C et al. Angiotensin pathways under therapy with empagliflozin in patients with chronic heart failure. ESC Heart Failure. 2023;10(3):1635–42. DOI: 10.1002/ehf2.14313
8. Packer M. Critical Reanalysis of the Mechanisms Underlying the Cardiorenal Benefits of SGLT2 Inhibitors and Reaffirmation of the Nutrient Deprivation Signaling/Autophagy Hypothesis. Circulation. 2022;146(18):1383–405. DOI: 10.1161/CIRCULATIONAHA.122.061732
9. Braunwald E. Gliflozins in the Management of Cardiovascular Disease. New England Journal of Medicine. 2022;386(21):2024–34. DOI: 10.1056/NEJMra2115011
10. Packer M. A reclassification of heart failure based on recognition of heart failure with normal to supernormal ejection fraction, a clinically common form of cardiac contracture, with distinctive pathophysiological and therapeutic features. European Journal of Heart Failure. 2023;25(5):669–72. DOI: 10.1002/ejhf.2849
11. Rosch S, Kresoja K-P, Besler C, Fengler K, Schöber AR, von Roeder M et al. Characteristics of Heart Failure With Preserved Ejection Fraction Across the Range of Left Ventricular Ejection Fraction. Circulation. 2022;146(7):506–18. DOI: 10.1161/CIRCULATIONAHA.122.059280
12. Ageev F.T., Ovchinnikov A.G., Ageeva S.F., Mareev V.Yu. What is “normal left ventricular ejection fraction” and its relationship with the pathogenesis and effectiveness of the treatment of heart failure. Kardiologiia. 2023;63(6):69–74. DOI: 10.18087/cardio.2023.6.n2404
Review
For citations:
Ageev F.T., Ovchinnikov A.G. Heart Failure With Low and Preserved Left Ventricular Ejection Fraction – are These Two Different Independent Diseases or One Disease, but at Different Stages of its Progression? How Does This Affect the Choice of Therapy and Its Effectiveness? Kardiologiia. 2023;63(10):4-8. https://doi.org/10.18087/cardio.2023.10.n2553
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