Preserving hope for patients with Heart Failure with Preserved Ejection Fraction?

Authors:
Gabrielle Givens, PharmD, BCPS
Robert Parker, PharmD

Reviewers:
Elizabeth Hearn, PharmD, BCACP
Jonathan Hughes, PharmD, BCPS, BCACP
Kelsea Woolfolk, PharmD, BCPS

Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med 2021;385:1451-61.

The Problem

Although guideline-directed medical therapy (GDMT) substantially improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), treatments that clearly improve outcomes in those with HF and an EF >40% remain elusive.¹ Patients with HF can be classified into three groups based on the left ventricular ejection fraction (LVEF): (1) preserved ejection fraction (HFpEF) with an LVEF ≥50%, (2) mid-range ejection fraction (HFmrEF) with an LVEF 41-49%, or (3) reduced ejection fraction (HFrEF) with an LVEF <40%.² Over 6.2 million adults in the United States have heart failure (HF) with about half having an EF >40%.  Unfortunately, the incidence and prevalence of HF are expected to substantially increase in the coming decades.³  More evidence and effective treatments for those with HFmrEF and HFpEF are clearly needed.