‘Game-changing’ treatment gets green light for HFpEF

This content has been independently produced by ADG, made possible through sponsorship from Boehringer Ingelheim and Eli Lilly.
Heart failure with preserved ejection fraction (HFpEF) affects more than half of patients with heart failure yet it is notoriously difficult to treat. In this Q&A, Professor David Kaye (pictured), director of cardiology at Melbourne’s Alfred Hospital, talks to ADG about a ‘game-changing’ treatment that’s been given the green light for HFpEF.
ADG: The global definitions of heart failure with preserved ejection fraction (HFpEF) vary slightly, so for our purposes, what is the Australian definition?
DK: Heart failure is first and foremost a clinical syndrome, so the patient will have symptoms consistent with heart failure. For HFpEF, exertional breathlessness is the most common symptom. Next, we must have evidence that heart function, at least the systolic function in terms of ejection fraction, is over 50%. That cut point is described in the Australian consensus statement which I think is a very helpful document. Finally, the patient will have some evidence of elevated filling pressures. This feature can be assessed in various ways including an echocardiogram or by measuring the natriuretic peptides. So really, there are three pieces to the puzzle: symptoms, evidence that the ejection fraction is over 50% and elevated filling pressures.