HFpEF Management: 5 Things to Know

4. Physicians need to be mindful to protect the right ventricle of patients with HFpEF.

Both pulmonary hypertension and RV dysfunction are highly prevalent in HFpEF. RV dysfunction probably results from a combination of impaired RV contractile function and elevated RV afterload. Longitudinal HFpEF studies have shown that RV structure and function worsen over time; this deterioration has been associated with atrial fibrillation, coronary artery disease, obesity, and increased left heart and pulmonary venous pressures.

As left heart filling pressures rise, the pulmonary vasculature becomes less compliant, increasing RV afterload. In addition, remodeling of the pulmonary vasculature, including intimal thickening in the veins and intimal and medial thickening in the arteries, may occur. Therefore, tailored diuretic therapy to normalize left heart filling pressures and prevent pulmonary congestion is a mainstay of treatment for patients with HFpEF. Discharge diuretics were recently associated with both a reduction in 30-day HF rehospitalizations and

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Stress Associated With HFpEF but Not HFrEF?

Stress was linked to higher long-term risk related to heart failure with preserved ejection fraction (HFpEF), researchers found from the large REGARDS cohort.

People who reported feeling more stress had more incident HFpEF-related death and hospitalization over a median follow-up of 10.1 years compared with peers scoring zero on the Perceived Stress Scale (PSS) assessment:

  • PSS score 1-2: adjusted HR 1.37 (95% CI 1.00-1.89)
  • PSS 3-4: adjusted HR 1.42 (95% CI 1.04-1.95)
  • PSS ≥5: adjusted HR 1.41 (95% CI 1.04-1.92)

In contrast, stress had no discernable relationship with incident HFrEF events, reported Lauren Balkan, MD, of Weill Cornell Medical Center in New York City, during her presentation at a moderated poster session at this year’s virtual conference of the Heart Failure Society of America.

HFpEF is thought to be a progressive systemic disorder influenced by aging and key comorbidities, such as chronic kidney disease and obesity. It is possible that

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A Small Step for Olive Oil as HFpEF Treatment

Extra virgin olive oil (EVOO) showed promise as a secondary prevention therapy for heart failure with preserved ejection fraction (HFpEF) in a small uncontrolled study.

Nine study participants with HFpEF and obesity were supplemented with unsaturated fatty acid-rich foods and had their EVOO intake estimated over 12 weeks according to their dietary recall, according to researchers led by Hayley Billingsley, RD, of Virginia Commonwealth University, who presented the data in a poster at this year’s virtual Heart Failure Society of American meeting.

Daily EVOO intake increased from zero at baseline to 23.6 g on average during the study, with greater EVOO consumption accompanied by small but significant improvements in cardiorespiratory fitness on cardiopulmonary exercise testing (CPET).

A statistical model indicated that a 40-g increase in EVOO intake led to increased peak VO2 by just under 2 mL/kg/min, a roughly 6% improvement compared with predicted peak VO2; oxygen

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