Treatment of heart failure with preserved ejection fraction.

Heart failure with preserved ejection fraction (HFpEF) is a major public health problem in the United States. However, in contrast to systolic heart failure, there are little data to guide treatment decisions in HFpEF, and no therapies have been shown to improve outcome in these patients. This review explores what is currently known about the pathophysiologic mechanisms causing HFpEF in order to frame appropriate therapeutic targets and better understand the clinical responses commonly observed in patients with HFpEF. Data from published clinical trials are reviewed, and the roles for each class of drug commonly used in practice are examined. Finally, novel therapies and future directions for basic investigation and clinical trials are discussed.