Heart Failure with Preserved Ejection Fraction; Epidemiology and Diagnosis

Heart failure (HF) is a complex syndrome in which the heart is incapable of meeting the circulatory demands for tissue needs. Furthermore, it develops secondary to systolic or/and diastolic left ventricular (LV) dysfunction. A left ventricular ejection fraction (LVEF) of 50% or more indicates HF with preserved ejection fraction (HFpEF), while a LVEF of less than 50% indicates HF with reduced ejection fraction (HFrEF).  HFpEF is a condition in which the LV cannot relax during the diastolic phase due to LV stiffness, resulting in an insufficient amount of blood being pumped into the body. Underlying comorbidities, such as aging, obesity, hypertension, and diabetes mellitus have been implicated as common underlying aetiologies associated with HFpEF. In addition, these comorbidities lead to disease exacerbation, myocardial abnormalities, and ultimately frequent hospitalization and death. However, there is no evidence-based treatment for HFPEF.

  • Epidemiology:


  • Prevalence and incidence.
  • Hospitalisation rate and mortality rate (I need 2 paragraphs comparing between HFpEF and HFrEF in different studies and make table represent Hospitalisation rate and mortality in different epidemiological studies for HFpEF)

Minimum evaluation 7 recent studies


Paragraph explanation, then table

Study name and Reference Population type and number Hospitalization rate Mortality rate



  • Epidemiological studies of HFpEF related age and gender (one paragraph).
  • Epidemiological studies of HFpEF related to common comorbidities such as obesity, hypertension, diabetes, atrial fibrillation, and pulmonary hypertension (two or more paragraphs + table). Minimum evaluation 7 recent studies. Example of table:
Study name and Reference Population type and number  Percentage of comorbidity 1  Percentage of comorbidity 2 Percentage of comorbidity 3


  • Present of obesity (BMI) and Hypertension in HFpEF (one paragraph and create a chart to represent the percentage of obesity and blood pressure in different studies for HFpEF) (minimum evaluation 7 recent studies)

Important crate a Chart to demonstrate the Present of obesity and Hypertension in HFpEF


  • Diagnosis
  • Recent clinical diagnosis Criteria + diagram figure summary (signs, symptoms, laboratory and imaging)
  • Recent score to estimate the probability of underlying heart failure with preserved ejection fraction (see The H2FPEF score).
  • Recent laboratory biomarker investigation such as natriuretic peptide (NP).
  • Recent molecular biomarker such as nitrotyrosine protein for oxidative stress, cGMP for endothelial dysfunction, C-reactive protein, interleukin (IL-6, 8, 10), and TNF (for inflammation), collagen pro-peptides, titin protein, expression of myosin-binding protein C (for cardiac remodelling), and other potential biomarkers

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