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Heart failure with preserved ejection fraction: Why is it so important to our hearts?
Heart failure is divided into two types, one of which is heart failure with preserved ejection fraction (HFpEF). In this condition, the heart's ejection fraction is normal, usually defined as greater than 50%. According to research, about half of heart failure patients have the HFpEF type, while the other half have heart failure with reduced ejection fraction (HFrEF). HFpEF is different from extreme heart failure, but the risks and symptoms are just as severe.
Patients with HFpEF often experience symptoms similar to those of HFrEF, including shortness of breath, poor exercise tolerance, and fatigue. Generalized edema is also a common sign.
Main risk factors for HFpEF
Risk factors for HFpEF include hypertension, obesity, diabetes, smoking, and obstructive sleep apnea. These risk factors not only increase the incidence of HFpEF but also lead to abnormal diastolic function of the heart, resulting in left ventricular stiffness and an increase in diastolic blood pressure.
Research has shown that dysregulated microvascular function and systemic inflammation can affect heart health, which is an important physiological characteristic of patients with HFpEF.
Pathophysiology of HFpEF
During the pathological process of HFpEF, structural changes in the heart are closely related to cellular changes. Patients with HFpEF often exhibit thickening of the ventricular walls, known as concentric hypertrophic heart disease, resulting in an increase in left ventricular mass and a relative decrease in chamber size.
Diastolic dysfunction of the heart
The core problem of HFpEF is diastolic dysfunction, a state in which the heart cannot relax normally during diastole, thereby affecting congestion and the heart's effective pumping. As the condition worsens, the heart's compliance decreases, which prevents the heart from working properly during exercise or other stressful situations.
This stiffness characteristic of the heart often causes pressure in the lungs to rise, eventually causing pulmonary edema, a dangerous complication.
Diagnostic methods of HFpEF
Diagnosis of HFpEF is usually assessed by echocardiography. This technology allows doctors to observe the diastolic function of the left ventricle, as well as other operating parameters of the heart. When an ultrasound of the heart does not give clear results, doctors may choose to perform a more detailed examination with catheterization, although this is considered an invasive procedure.
Treatment and Management
At present, the treatment of HFpEF mainly focuses on improving the patient's quality of life and relieving symptoms. This includes through lifestyle changes such as increasing physical activity, improving diet, and losing weight. In addition, medication for hypertension and other related conditions is important.
Exercise has been shown to enhance exercise tolerance and improve overall heart health in patients with HFpEF.
The future of HFpEF
As our understanding of HFpEF continues to deepen, more targeted treatment options and continued research may emerge in the future to improve patient prognosis. Scientists continue to explore the relationship between inflammation and heart disease and seek new ways to reduce the incidence and impact of HFpEF.
HFpEF is a complex pathological condition. How to effectively diagnose, manage and ultimately improve the quality of life of these patients is still a topic that we need to think deeply about.
