ABC Heart Fail Cardiomyop 2022; 2(1): 72-75
Clinical Profile-Based Pharmacological Sequencing for Heart Failure with Preserved Ejection Fraction
Evandro Tinoco Mesquita
, Eduardo Thadeu de Oliveira Correia, Letícia Mara dos Santos Barbetta
Introduction
Heart failure (HF) is classically categorized into phenotypes according to left ventricular ejection fraction (EF), one of them being HF with preserved EF (HFpEF; EF ≥ 50%). In the past decades, a myriad of drug therapies that reduce mortality and hospitalization rates for HF with reduced EF have emerged. However, although HFpEF accounts for about 50% of HF cases, to this date, only empagliflozin was shown to reduce HF hospitalization, and no drug reduced the risk for cardiovascular death in randomized clinical trials (RCTs). One hypothesis that may explain the lack of therapies that reduce hard outcomes in HFpEF is the variety of phenotypes that constitute HFpEF as a syndrome. Thus, in this paper, we discuss evidence from RCTs and post-hoc analyses of RCTs that may help improve HFpEF outcomes, aid clinicians, and pave the way for future RCTs.
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