Nonpharmacological Approaches to Managing Heart Failure With Preserved Ejection Fraction.
Feiyang TangHaofu HanSheng FuQi Ming LiuShenghua ZhouJiapeng HuangYichao XiaoPublished in: Circulation. Heart failure (2024)
Heart failure with preserved ejection fraction (HFpEF) is a common subtype of heart failure marked by impaired left ventricular diastolic function and decreased myocardial compliance. Given the limited availability of evidence-based pharmacological treatments for HFpEF, there is a growing interest in nonpharmacological interventions as viable therapeutic alternatives. This review aims to explore the pathophysiology of HFpEF and present recent advancements in nonpharmacological management approaches, encompassing noninvasive therapies, invasive procedures and targeted treatments for comorbidities. An extensive literature review was undertaken to identify and synthesize emerging nonpharmacological treatment options for HFpEF, assessing their potential to enhance patient outcomes. Nonpharmacological strategies, such as vagus nerve stimulation, percutaneous pulmonary artery denervation, renal denervation, transcatheter insertion of atrial shunts and pericardial resection, demonstrate promising potential for alleviating HFpEF symptoms and improving patient prognosis. Moreover, addressing comorbidities, such as hypertension and diabetes, may offer additional therapeutic benefits. These cutting-edge techniques, in conjunction with well-established exercise therapies, pave the way for future research and clinical applications in the field. Nonpharmacological interventions hold promise for advancing HFpEF patient care and fostering a deeper understanding of these treatment approaches, which will facilitate new clinical applications and contribute to the development of more targeted therapies.
Keyphrases
- left ventricular
- pulmonary artery
- heart failure
- blood pressure
- physical activity
- coronary artery
- pulmonary hypertension
- pulmonary arterial hypertension
- case report
- type diabetes
- atrial fibrillation
- cardiac resynchronization therapy
- hypertrophic cardiomyopathy
- left atrial
- acute myocardial infarction
- high intensity
- cardiovascular disease
- acute coronary syndrome
- machine learning
- human health
- depressive symptoms
- mitral valve
- risk assessment
- percutaneous coronary intervention
- big data
- skeletal muscle
- ejection fraction
- sleep quality