Journal of Cardiac Failure
Volume 15, Issue 7 , Pages 561-564 , September 2009

Heart Failure With a Normal Ejection Fraction (HFNEF): Embracing Complexity

  • Mathew S. Maurer, MD

      Affiliations

    • Corresponding Author InformationReprint requests: Mathew S. Maurer, Clinical Cardiovascular Research Laboratory for the Elderly, Columbia University Medical Center, Allen Pavilion of New York Presbyterian Hospital, 5141 Broadway, 3 Field West Room 035, New York, NY 10034.

References 

  1. Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251–259
  2. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation. 2003;107:139–146
  3. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. Part II: the aging heart in health: links to heart disease. Circulation. 2003;107:346–354
  4. Burkhoff D, Maurer MS, Packer M. Heart failure with a normal ejection fraction: is it really a disorder of diastolic function?. Circulation. 2003;107:656–658
  5. Maurer MS, King DL, El-Khoury RL, Packer M, Burkhoff D. Left heart failure with a normal ejection fraction: identification of different pathophysiologic mechanisms. J Card Fail. 2005;11:177–187
  6. Lam CS, Roger VL, Rodeheffer RJ, et al. Cardiac structure and ventricular-vascular function in persons with heart failure and preserved ejection fraction from Olmsted County, Minnesota. Circulation. 2007;115:1982–1990
  7. Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure—abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350:1953–1959
  8. Melenovsky V, Borlaug BA, Rosen B, et al. Cardiovascular features of heart failure with preserved ejection fraction versus nonfailing hypertensive left ventricular hypertrophy in the urban Baltimore community: the role of atrial remodeling/dysfunction. J Am Coll Cardiol. 2007;49:198–207
  9. Borlaug BA, Melenovsky V, Russell SD, et al. Impaired chronotropic and vasodilator reserves limit exercise capacity in patients with heart failure and a preserved ejection fraction. Circulation. 2006;114:2138–2147
  10. Kawaguchi M, Hay I, Fetics B, Kass DA. Combined ventricular systolic and arterial stiffening in patients with heart failure and preserved ejection fraction: implications for systolic and diastolic reserve limitations. Circulation. 2003;107:714–720
  11. Hummel SL, Skorcz S, Kollering TM. Prolonged electrocardiogram QRS duration independently predicts long-term mortality in patients hospitalized for heart failure with preserved systolic function. J Card Fail. 2009;15:553–560
  12. Bhatia RS, Tu JV, Lee DS, et al. Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med. 2006;355:260–269
  13. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428
  14. Massie BM, Carson PE, McMurray JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med. 2008;359:2456–2467
  15. Cleland JG, Tendera M, Adamus J, Freemantle N, Polonski L, Taylor J. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J. 2006;27:2338–2345
  16. Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777–781
  17. Lee PY, Alexander KP, Hammill BG, Pasquali SK, Peterson ED. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA. 2001;286:708–713
  18. Norris SL, High K, Gill TM, et al. Health care for older Americans with multiple chronic conditions: a research agenda. J Am Geriatr Soc. 2008;56:149–159
  19. Henkel DM, Redfield MM, Weston SA, Gerber Y, Roger VL. Death in heart failure: a community perspective. Circ Heart Fail. 2008;1:91–97
  20. Fries JF. The compression of morbidity. Milbank Q. 2005;83:801–823

 The Department of Medicine at Columbia University Medical Center has maintained a 2 attending system for rounds despite the time and financial pressures of modern medicine. For the attendings, this remains one of the best experiences as it provides for exchange of ideas and ongoing professional development.

 Dr. Maurer is supported by a grant from the NIH/NIA (R01AG027518-01A1).

PII: S1071-9164(09)00137-7

doi: 10.1016/j.cardfail.2009.04.004

Journal of Cardiac Failure
Volume 15, Issue 7 , Pages 561-564 , September 2009