Patient Phenotype Profiling in Heart Failure with Preserved Ejection Fraction to Guide Therapeutic Decision Making. A Scientific Statement of the Heart Failure Association, the European Heart Rhythm Association of the European Society of Cardiology, and the European Society of Hypertension
Stefan D. Anker, Muhammad Usman, Markus S. Anker, Javed Butler, Michael Böhm, William T. Abraham, Marianna Adamo, Vijay Chopra, Mariantonietta Cicoira, Francesco Cosentino, Gerasimos Filippatos, Ewa A. Jankowska, Lars H. Lund, Brenda Moura, Wilfried Müllens, Burkert Pieske, Piotr Ponikowski, José Ramón González‐Juanatey, Amina Rakisheva, Gianluigi Savarese, Petar Seferović, John R. Teerlink, Carsten Tschöpe, Maurizio Volterrani, Stephan von Haehling, Jian Zhang, Yuhui Zhang, Johann Bauersachs, Ulf Landmesser, Shelley Zieroth, Konstantinos Tsioufis, Antoni Bayés‐Genís, Ovidiu Chioncel, Felicita Andreotti, Enrico Agabiti‐Rosei, José Luís Merino, Marco Metra, Andrew J.S. Coats, Giuseppe Rosano
Abstract
Heart failure with preserved ejection fraction (HFpEF) represents a highly heterogeneous clinical syndrome affected in its development and progression by many comorbidities. The left ventricular diastolic dysfunction may be a manifestation of various combinations of cardiovascular, metabolic, pulmonary, renal, and geriatric conditions. Thus, in addition to treatment with sodium-glucose cotransporter 2 inhibitors in all patients, the most effective method of improving clinical outcomes may be therapy tailored to each patient's clinical profile. To better outline a phenotype-based approach for the treatment of HFpEF, in this joint position paper, the Heart Failure Association of the European Society of Cardiology, the European Heart Rhythm Association and the European Hypertension Society, have developed an algorithm to identify the most common HFpEF phenotypes and identify the evidence-based treatment strategy for each, while taking into account the complexities of multiple comorbidities and polypharmacy.