a.k.a. Diastolic HF

• EF ≥ 50%

• Heart is too stiff (cannot relax → decrease preload)

• Concentric Hypertrophy

• Normal sized LV

• Pressure overload

• Worse prognosis vs. HFrEF

  

Management: Chronic HFpEF

Medication (not improving survival rate)

• Pharmacotherapy - focus on reducing hospitalizations
  • SGLT2i (”gliflozin”)
  • Consider ARB (-sartan) - “Candesartan - CHARM-Preserved”
  • Consider MRA - TOPCAT
  • Consider ARNI - especially if LVEF 40-50%
• Diuretics if congestion occurs
• Treat CAD and OSA - Obstructive Sleep Apnea