Heart failure with preserved ejection fraction: Pathophysiology, diagnosis, and treatment

Barry A. Borlaug, Walter J. Paulus

Research output: Contribution to journalReview articlepeer-review

674 Scopus citations


Half of patients with heart failure (HF) have a preserved left ventricular ejection fraction (HFpEF). Morbidity and mortality in HFpEF are similar to values observed in patients with HF and reduced EF, yet no effective treatment has been identified. While early research focused on the importance of diastolic dysfunction in the pathophysiology of HFpEF, recent studies have revealed that multiple non-diastolic abnormalities in cardiovascular function also contribute. Diagnosis of HFpEF is frequently challenging and relies upon careful clinical evaluation, echo-Doppler cardiography, and invasive haemodynamic assessment. In this review, the principal mechanisms, diagnostic approaches, and clinical trials are reviewed, along with a discussion of novel treatment strategies that are currently under investigation or hold promise for the future.

Original languageEnglish (US)
Pages (from-to)670-679
Number of pages10
JournalEuropean heart journal
Issue number6
StatePublished - Mar 2011


  • Diagnosis
  • Diastolic
  • Ejection fraction
  • Heart failure
  • Pathophysiology
  • Preserved ejection fraction
  • Systolic
  • Treatment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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