Understanding heart failure with preserved ejection fraction: Clinical importance and future outlook

Alan B. Miller, Ileana L. Piña

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Heart failure (HF) with preserved ejection fraction (HF-PEF) accounts for approximately one half of all HF patients admitted with acute decompensated HF and carries a significant morbidity and mortality burden. This condition, however, has been largely understudied because it is difficult to diagnose, and management guidelines are still being discussed. This article provides an overview of HF-PEF and its pathophysiology, diagnosis, and treatment, with a focus on clinical trials using renin-angiotensin-aldosterone system (RAAS) blockers. Inhibitors of the RAAS have been studied in HF-PEF to determine whether their benefits extend beyond blood pressure control. However, the 3 trials conducted to date (CHARM-Preserved, PEP-CHF, and I-PRESERVE) with candesartan, perindopril, and irbesartan, have failed to demonstrate significant morbidity and mortality benefits. Although no agent has proven statistically significant benefits in morbidity and mortality in HF-PEF, recent studies have added to the breadth of clinical data and understanding of the demographics of these patients.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalCongestive Heart Failure
Issue number4
StatePublished - 2009
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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