ABC | Volume 114, Nº1, January 2019

Review Article Fernandes et al. Heart Failure with Preserved Ejection Fraction Arq Bras Cardiol. 2020; 114(1):120-129 1. Yancy CW, Januzzi JL, Allen LA, Butler J, Davis LL, Fonarow GC, et al. 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart FailureWith Reduced Ejection Fraction. J Am Coll Cardiol. 2017;71(2):201-30. 2. Riet EE, Hoes AW,Wagenarr KP, Limburg A, LandmanMA. Epidemiologia da Insuficiência Cardíaca: prevalência da insuficiência cardíaca e da disfunção ventricular nos idosos ao longo do tempo. Revisão sistemática. Rev Port Cardiol. 2017;36(5):405-7. 3. Ponikowski P, Voors AA, Anker SD, Bueno Héctor, Cleland JGF, Coats AJ, et al. 2016 ESCGuidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37(27):2129-200. 4. AltayH,PehlivanogluS.HeartFailurewithPreservedEjectionFraction.In:KiraliK, editors.Cardiomyopathies-TypesandTreatments.IntechOpen;2017.p.39-53. 5. 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Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis. Heart . 2018;104(5):407-15. 11. Sá FM, Carvalho R, Ruivo C, Santos LG, Antunes A, Soares F. Beta- blockers for post-acute coronary syndrome mid- range ejection fraction: a nationwide retrospective study. Eur Heart J Acute Cardiovasc Care. 2019 Feb 4:2048872619827476. doi: 10.1177/2048872619827476. [Epub ahead of print] 12. Massie BM, Carson PE, McMurray JJ, Komajda M, McKelvie M, Zile MR, et al. Irbesartan in Patients withHeart Failure and Preserved Ejection Fraction. N Engl J Med . 2008;359(23)2456-67. 13. Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJV, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM- Preserved Trial. Lancet . 2003;362(9368):777-81. 14. Cleland JGF, Tendera M, Adamus J, Freemantle N, Polonski L, Taylor J. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J . 2006;27(19):2338-45. 15. Kitzman DW, HundleyWG, Brubaker PH, Morgan TM, Moore JB, Stewart KP, et al. A Randomized Double-Blind Trial of Enalapril in Older Patients With Heart Failure and Preserved Ejection Fraction: effects on Exercice Tolerance and Arterial Distensibility. Circ Hear Fail . 2010;3(4):477-85. 16. Edelmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, KamkeW, et al. Effect of Spironolactone on Diastolic Function and Exercise Capacity in Patients With Heart Failure With Preserved Ejection Fraction. JAMA . 2013;309(8):781-91. 17. Pitt B, Pfeffer M, Assmann SF, Boineau R, Anand IS, Claggett B, et al. Spironolactone for Heart Failure with Preserved Ejection Fraction. N Engl J Med . 2014;370(15):1383-92. 18. Yancy CW, Jessup M, Levine GN, Halperin JL. 2017 ACC / AHA / HFSA Focused Update of the 2013 ACCF / AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America.. J Am Coll Cardiol. 2017;70(6):776-803. 19. Solomon SD, Zile M, Pieske B, Voors A, Shah A, Kraigher-Krainer E, et al. The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial. Lancet . 2012;380(9851):1387-95. 20. SolomonSD,RizkalaAR,GongJ,MangW,AnandIS,GeJ,etal.AngiotensinReceptor NeprilysinInhibitioninHeartFailureWithPreservedEjectionFractionRationaleand DesignofthePARAGON-HFTrial. JACCHeartFail .2017;5(7):471-82. 21. Komajda M, Isnard R, Cohen-solal A, Metra M, Pieske B, Ponikowski P, et al. Effect of ivabradine in patients with heart failure with preserved ejection fraction: the EDIFY randomized placebo-controlled trial ivabradine studY (EDIFY). Eur J Heart Fail. 2017;19(11):1495-503. References factors that culminate in the reduction of cardiac and vascular functional reserve - systolic and diastolic dysfunction, atrial reserve, heart rate and rhythm, autonomic control, vasculature and microcirculation. The interaction and relative dominance of these factors make this pathology extremely heterogeneous. The definition and division into subgroups with certain phenotypes may allow a more targeted treatment, with possible improvement of the clinical results. Several clinical trials are being carried out, using different therapeutic approaches. It is important to remember that these patients tend to be older and have multiple pathologies. Thus, the benefit of the treatments may be better evaluated by their effect on hospitalizations, functional status, symptoms and quality of life. Author contributions Conception and design of the research, Acquisition of data andWriting of the manuscript: Fernandes SL; Critical revision of the manuscript for intellectual content: Carvalho RR, Santos LG, Sá FM, Ruivo C, Mendes SL, Martins H, Morais JA. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 128