"There is an ongoing diagnostic uncertainty with several varying diagnostic criteria proposed by societies and clinical trials 3,4. A simplified approach recommended by the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure were the following criteria 3:"
"Serologically circulating natriuretic peptides as NT-proBNP or BNP (brain natriuretic peptide) will be typically elevated 1. The following values can be considered as abnormal 3,5:"
"NT-proBNP >125 pg/mL in sinus rhythm or >365 pg/mL in atrial fibrillation"
"infiltrative cardiomyopathies such as cardiac ATTR (transthyretin) amyloidosis (in up to 13-19%)"
"Scintigraphy with a technetium pyrophosphate scan can be helpful in the setting of ATTR amyloidosis 4."
"The EMPEROR-Preserved trial showed a significant reduction of the combined risk of cardiovascular death and hospitalisation for heart failure by 21% after administration of empagliflozin 10, a sodium glucose co-transporter-2 (SGLT-2) inhibitor in the renal proximal tubules, in patients with a left ventricular ejection fraction of more than 40%. Similarly positive findings were found in the DELIVER trial of dapagliflozin 15."
"The EMPEROR-Preserved trial showed a significant reduction of the combined risk of cardiovascular death and hospitalisation for heart failure by 21% after administration of empagliflozin 10, a sodium glucose co-transporter-2 (SGLT-2) inhibitor in the renal proximal tubules, in patients with a left ventricular ejection fraction of more than 40%. Similarly positive findings were found in the DELIVER trial of dapagliflozin 15."
"E/e’ or E/A ratios at rest"
Expected headings
"Associations"
"Echocardiography"
"Coronary angiography"
"There is an ongoing diagnostic uncertainty with several varying diagnostic criteria proposed by societies and clinical trials 3,4. A simplified approach recommended by the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure were the following criteria 3:"
"objective evidence of structural, functional and serological cardiac abnormalities in keeping with diastolic dysfunction and increased left ventricular filling pressures"
"Other factors contributing to the limitation of systolic reserve capacity and increase in filling pressures, and thus diastolic and systolic dysfunction, include left atrial dysfunction, chronotropic incompetence, atrial fibrillation, autonomic imbalance, arterial stiffening, endothelial dysfunction, and peripheral impairments in skeletal muscle and body composition 6."
"Cardiac MRI can reliably assess cardiac function, including cardiac volumes and measurements and ventricular wall thickness. However, its main task in the setting of heart failure with preserved ejection fraction is the aetiological workup, the detection of myocardial fibrosis, and the identification of infiltrative cardiomyopathies or inflammatory conditions such as cardiac amyloidosis, Fabry disease, cardiac sarcoidosis or myocarditis 2,9."
"ischaemic heart disease (e.g. myocardial scarring, myocardial stunning, microvascular dysfunction)"
"toxins (e.g. alcohol, heavy metals, medications, radiation etc.)"
"immune or inflammatory heart disease (e.g. myocarditis, rheumatoid arthritis)"
"infiltrative cardiomyopathies (e.g. cardiac amyloidosis, cardiac sarcoidosis, storage disorders)"
"metabolic conditions (e.g. thyroid disease, thiamine deficiency etc.)"
"genetic conditions (e.g. hypertrophic cardiomyopathy, muscular dystrophy)"
"endocardial disease (e.g. endocardial fibroelastosis)"
"high output states (e.g. anaemia, sepsis, thyrotoxicosis)"
"volume overload (e.g. renal failure)"
"History and etymology"