Heart failure with preserved ejection fraction: updated diagnostic and therapeutic strategies. SEMI consensus document

Heart failure (HF) is associated with high morbidity and mortality. HF with preserved left ventricular ejection fraction (HF-pEF) accounts for up to 50% of all HF cases, being the most common in elderly patients. In addition, these subjects frequently present other comorbidities. For all these reasons, the diagnosis of patients with HF-pEF is complex and requires a careful approach. In addition, there are "secondary" or HF-pEF forms that must also be discarded. The treatment of HF-pEF has evolved very significantly in recent years due to evidence from clinical trials. Until a few years ago, the management was based on the treatment of congestive symptoms with diuretics and comorbidities, to this was added the indication of treatment with SGLT2 inhibitors, after being shown to reduce hospitalizations due to HF, and more recently new evidence of clinical benefit with other drugs such as finerenone, semaglutide or tirzepatide has been published. All this makes it necessary to update the recommendations regarding the management of patients with HF-pEF.