Abstract

Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome in which patients have signs and symptoms of HF as the result of high left ventricular (LV) filling pressure despite normal or near normal LV ejection fraction (LVEF; ≥50 percent). Management of HFpEF focuses on: 1. Risk stratification and management of comorbidities, including hypertension, DM, obesity, AF, CAD, CKD, and obstructive sleep apnea; 2. Nonpharmacological management, including the role of exercise and weight loss and the use of wire- less, implantable pulmonary artery monitors;    and 3. Symptom management and disease-modifying therapy with loop diuretic agents, SGLT2is, mineralocorticoid antagonists (MRAs), angiotensin receptor– neprilysin inhibitors (ARNIs), and angiotensin receptor blockers (ARBs). Recent clinical trials have demonstrated the benefit of GDMT in individuals with HFpEF, and initiation of key agents is essential to improve symptoms and functional capacity and reduce the morbidity and mortality associated with HF.