Heart failure with preserved ejection fraction: A distinct heart failure phenotype?

Figure 1 It is irrational to believe that the management of a group of diseases covered under the term heart failure with preserved ejection fraction should be based on a single biomarker, namely the left ventricular ejection fraction, as the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Preserved Ejection Fraction implies. It is noteworthy, that like all trials which demonstrated a potential benefit with medical treatment in heart failure with preserved ejection fraction, more than 90% of the patients in Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Preserved Ejection Fraction were hypertensive and, in contrast to other HFpEF trials, patients with valvular heart disease or hypertrophic cardiomyopathy were not included suggesting a selection bias. LV: Left ventricular; CPX: Cardiopulmonary exercise testing; 6MW: 6 min walk test; LVER: Left ventricular ejection fraction; HFpEF: Heart failure with preserved ejection fraction.