Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) occurs when the heart muscle is unable to properly relax and fill with blood. As a result, the heart’s output is decreased, even though its pumping function as measured by its ejection fraction (the percentage of blood ejected with each contraction) is preserved and remains near normal.
Studies show that heart failure with preserved ejection fraction is more common among women than men, although the reasons are unclear. At Tampa General Hospital, we fully support gender equity in healthcare, and the multidisciplinary team in the Women’s Heart Program at the TGH Heart and Vascular Institute provides specialized prevention, diagnostic and treatment services for women at every stage of life.
Heart Failure With Preserved Ejection Fraction Causes
Not all cases of HFpEF have an easily identifiable cause. Experts believe it most likely results from a combination of several factors, which may include:
- Age-related changes in the heart’s structure and function
- High blood pressure (hypertension)
- Atrial fibrillation (AFib)
- Valvular heart disease
- Uncontrolled diabetes
- Chronic inflammation
- Chronic kidney disease
- Obesity or excess body weight
- A sedentary lifestyle
What Are the Symptoms of Heart Failure With Preserved Ejection Fraction?
The signs of HFpEF can be similar to those of other types of heart failure, such as:
- Shortness of breath (dyspnea)
- Overwhelming fatigue
- Fluid retention and swelling in the abdomen, legs, ankles and feet (edema)
- Persistent coughing
- Irregular heartbeat
- Reduced urine output
How Is Heart Failure With Preserved Ejection Fraction Diagnosed?
The diagnostic process for HFpEF involves a combination of clinical assessments and medical tests, which may include:
- A physical examination and medical history review
- Blood testing for cardiac markers, such as B-type natriuretic peptide (BNP)
- An electrocardiogram (EKG)
- An echocardiogram
- Cardiac magnetic resonance imaging (MRI) scans of the heart
- Exercise stress testing
- Cardiac catheterization
How Is Heart Failure With Preserved Ejection Fraction Treated?
Heart failure with preserved ejection fraction is a complex condition that can affect men and women—as well as individuals of the same gender—differently. Because each patient has a unique risk profile and contributing factors, there is no single, universally effective treatment strategy. Instead, a physician will typically work closely with the patient to develop a personalized plan to help relieve the symptoms.
When applicable, a key aspect of treating HFpEF is controlling any underlying medical conditions, such as hypertension, AFib, diabetes and/or kidney disease. Additionally, many patients benefit from:
- Diuretics to reduce fluid buildup
- Reduced sodium intake
- Regular exercise
- Weight management
- Smoking cessation
- Alcohol moderation
After treatment begins, regular follow-up care is important. This will allow the physician to continually monitor the patient’s symptoms and overall health and finetune the treatment plan as needed.
Benefit From World-Class Care at TGH
Heart failure with preserved ejection fraction requires specialized care to ensure the best possible outcome and quality of life. The multidisciplinary cardiac team in TGH’s Interventional Heart Failure Program offers a robust array of services that complement those available through our Women’s Heart Program. If you would like to talk with an expert at TGH, contact us at (813) 844-3900 to set up an appointment.