HFpEF

Question 1

HFpEF

Answer 1

-Preserved EF >50% + sx
-DIASTOLIC dysfunction: impaired ventricular relaxation
-many pt have combo systolic and diastolic dysfunction
-HTN most common cause

Question 2

Most common cause of HFpEF

Answer 2

-HTN

Question 3

HFpEF tx summary

Answer 3

1. diuretics as needed (no reduction in mortality)
2. SGLT2i (iffy but diuretic effect)

-ACE/ARBs MAYBE dec hospitalizations at lower end of LVEF
-MRA maybe reduce hospitalization
-manage AF (anticoagulation/slow HR)
-NO digoxin
-limit nitrates
-CCBs for HTN
-BB okay

Question 4

Diuretics for HFpEF

Answer 4

-relief for volume overload
-no mortality benefits

Question 5

SGLT2i in CV mortality

Answer 5

-iffy but diuretic effect

Question 6

ACE/ARB/ARNi use in HFpEF

Answer 6

-no reduction in mortality
-may reduce hospitalizations
-ACE improves exercise tolerance

Question 7

MRA use in HFpEF

Answer 7

-may imrpove diastolic function
-may reduce remodeling
-may reduce hospitalizations
-may use if appropriate but less convincing than HFrEF

Question 8

Digoxin use in HFpEF

Answer 8

-NO
-makes things worse

Question 9

Nitrate use in HFpEF

Answer 9

-limit to only pt that need sx CAD tx

Question 10

CCB use in HFpEF

Answer 10

-maybe useful for HTN
-slow HR and improve filling

Question 11

BB use in HFpEF

Answer 11

-ok

Question 12

GLP-1s in HFpEF

Answer 12

-could be promising
-benefits due to DM, obesity, maybe HFpEF? need more info