ABC Heart Fail Cardiomyop 2022; 2(3): 322-325

The Importance of Controlling Comorbidities in HFpEF and How They Influence Disease Evolution

Conrado Roberto Hoffmann Filho , André R. Duraes , Gilmar Sidnei Erzinger

DOI: 10.36660/abchf.20220070

Heart failure (HF) is a disease with high morbidity and mortality in Brazil and in the world, and HF with preserved ejection fraction (HFpEF) accounts for more than half of cases. Effective pharmacological treatment options for HFpEF are scarce, with poor outcomes and an annual mortality of 10 to 30%. Mortality from noncardiovascular causes is high, which is to be expected given the high number of comorbidities (). The syndromic diagnosis is composed of several etiologies and diseases, each one with a specific treatment but with common aspects regarding clinical presentation.

An approach based on the different phenotypes of the disease was proposed, which comprises multiple situations experienced by the group of patients with HFpEF. Each phenotype is dependent on the different presentations of comorbidity severity, which constitutes a challenge for the definitive clinical diagnosis of HFpEF by a clinical cardiologist. Diagnostic scores with probabilistic models were developed to facilitate HFpEF diagnosis, using clinical, echocardiographic, and biomarker variables, such as B-type natriuretic peptide (BNP) and N-terminal portion of BNP. A more detailed description of the diagnosis is beyond the scope of this article.

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