#153 HFpEF: 5 Pearls Segment

The podcast episode addresses the complexities and misconceptions surrounding heart failure with preserved ejection fraction (HFpEF). It clarifies that HFpEF is a syndrome influenced by systemic inflammation and cardiometabolic risk factors, rather than solely a heart condition and that HFpEF is more common in older adults and women. The discussion emphasizes that diastolic dysfunction and elevated BNP levels do not automatically confirm HFpEF, as normal echo findings and BNP levels can occur in HFpEF patients, especially those with obesity or LV hypertrophy. Diagnostic strategies involve risk scores and advanced testing like right heart catheterization to provoke symptoms during exercise. Management includes addressing risk factors and using SGLT2 inhibitors as a first-line treatment, with mineralocorticoid receptor antagonists or ARNIs considered as second-line options.