Heart failure with preserved ejection fraction: the role of diastolic stress test in diagnostic algorithms

Abstract

Heart failure (HF) with preserved ejection fraction (HFpEF) is currently the most common type of this condition, especially among elderly patients. Despite the preserved left ventricular (LV) and a moderate increase in natriuretic peptide, patients with HFpEF have the same out-of-hospital mortality as those with HF with reduced ejection fraction (HFrEF). Diagnosis of HFpEF is difficult due to nonspecific symptoms, expensive blood tests, and questionable rest echocardiographic data on diastolic function. In addition, the reason for poor diagnosis of HfpEF in clinical practice may be old age and comorbidities, which can also cause nonspecific symptoms of moderate chronic shortness of breath, weakness, and palpitations. The consequence is the detection of HFpEF only in every fourth patient with an acute or chronic heart failure. The use of simplified clinical diagnostic protocols along with a non-invasive ultrasound stress test can help overcome the existing problems in the diagnosis of HFpEF.