General Principles, Clinical Definition, Epidemiology, and Pathophysiology

Heart failure with preserved ejection fraction is a distinct clinical entity with a unique pathophysiology. The prevalence increases with age, while the survival has remained stable. The treatment of comorbid conditions remains the cornerstone of therapy. Despite this, it is a highly morbid condition, with survival rates similar to heart failure with reduced ejection fraction. Exercise intolerance is a hallmark of the disease and is thought to be due to a complex interplay between endothelial dysfunction, neurohormonal disarray, and the periphery. No therapies to date have been shown to improve survival.