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The Curbsiders Internal Medicine Podcast
#460 HFpEF: Heart Failure with Preserved Ejection Fraction
Nov 4, 2024
Dr. Michelle Kittleson, a heart failure expert and professor at Cedars-Sinai, discusses the complexities of heart failure with preserved ejection fraction (HFpEF). She breaks down the challenges of diagnosing this condition and introduces the H2F-PEF score for assessment. The conversation covers managing comorbidities, the positive impact of weight loss and exercise, and highlights promising results from GLP-1 receptor agonists. Kittleson emphasizes the importance of recognizing unique patient needs and adjusting treatment strategies accordingly.
49:39
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Quick takeaways
- HFPEF diagnosis relies heavily on comprehensive assessments and differentiating it from similar conditions like liver or kidney disease.
- Management of HFPEF should focus on treating comorbidities alongside guideline-directed medical therapy, including SGLT2 inhibitors and lifestyle modifications.
Deep dives
Introduction to Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFPEF) presents unique challenges in diagnosis and treatment, primarily characterized by symptoms of dyspnea and edema in patients whose ejection fraction remains normal or above 50%. Unlike heart failure with reduced ejection fraction, where clear diagnostic criteria exist, HFPEF requires comprehensive assessments to determine the underlying cause of the symptoms. A thorough history and physical examination are essential to differentiate HFPEF from other potential causes, including liver or kidney conditions that can mimic heart failure. The complexity of HFPEF stems from its multifactorial nature, necessitating a careful evaluation of various contributing factors, including patient demographics and coexisting conditions.
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