Update: Herzinsuffizienz mit erhaltener Pumpfunktion

Was ist neu?

Diagnosestellung Die 2021 erschienene Herzinsuffizienz-Leitlinie der Europäischen Gesellschaft für Kardiologie (ESC) hat die Diagnosestellung etwas vereinfacht. Sie listet die Diagnosekriterien gleichwertig, ohne das Vorliegen einer bestimmten Anzahl von Kriterien zu fordern.

Ätiologie Eine Expertengruppe der Herzinsuffizienz-Vereinigung (HFA: Heart Failure Association) und der Rhythmus-Vereinigung (EHRA: European Heart Rhythm Association) der ESC sowie der Europäischen Gesellschaft für Hypertonie unternahm den Versuch, durch detaillierte Phänotypisierung pathophysiologisch und therapeutisch distinkte Profile an HFpEF-Patienten herauszuarbeiten.

Therapie In einem unlängst erschienenen Update der Leitlinie wurden auf der Basis neu gewonnener Evidenz erstmals konkrete Empfehlungen zur Pharmakotherapie der HFpEF formuliert. Die Kontrolle der Risikofaktoren und ein gesunder Lebensstil bleiben weiterhin von großer therapeutischer Bedeutung.

Abstract

Heart failure with a preserved ejection fraction (HFpEF) is a multifaceted disease entity. Confirming the diagnosis as well as tailoring the most appropriate therapy remains an ongoing challenge. The 2021 heart failure guidelines of the European Society of Cardiology (ESC) suggested a simplified diagnostic approach, and the guideline update provided in 2023 gave recommendations regarding pharmacotherapy based on recent evidence. Further, the Heart Failure Association (HFA) and the European Heart Rhythm Association of the ESC jointly proposed a scheme how to classify HFpEF patients into phenogroups of distinct pathophysiology that may benefit from individually targeted treatment. Regarding HFpEF originating from secondary causes, e.g. M. Fabry, amyloidosis or hypertrophic cardiomyopathy, there are emerging therapeutic options with the potential to substantially improve the physical capacity, quality of life and prognosis in these patients. The here presented update gives an overview on the recent advances in the area of HFpEF.

Schlüsselwörter

Herzinsuffizienz mit erhaltener Pumpfunktion - HFpEF - Phänotyp - Diagnose - Therapie

Keywords

Heart failure with preserved ejection fraction - HFpEF - phenogroup - diagnosis - therapy

Publication History

Article published online:
27 February 2024

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