Insuficiencia cardíaca crónica con fracción de eyección del ventrículo izquierdo conservada

Abstract

Heart failure with preserved ejection fraction (HFpEF) is defined as a clinical syndrome characterized by the presence of symptoms and/or signs arising from a structural and/or functional abnormality of the heart at rest or on exertion. It is accompanied by elevated natriuretic peptide levels or objective evidence of diastolic dysfunction and preserved left ventricular ejection fraction (equal to or greater than 50%). It is a heterogeneous syndrome whose diagnosis requires ruling out diseases that may justify the symptoms (respiratory diseases, coronary artery disease, valvular or hypertensive heart disease, or cardiomyopathies, among others). It is essential to perform an electrocardiogram, NT-proBNP measurement, and echocardiogram in addition to additional tests according to the patient's clinical context (computed tomography coronary angiogram and cardiac magnetic resonance imaging, among others). Current guidelines recommend the use of diuretics and treatment with SGLT2is to reduce congestive symptoms and the risk of hospitalization due to HF. There are currently no pharmacological treatments that have demonstrated a decrease in mortality in this group of patients. Recent studies suggest that glucagon-like peptide-1 receptor agonists (GLP1-ra) may improve quality of life and decrease symptoms in patients with HFpEF and obesity.