HFpEF Diagnosis Enters a New Era
HFpEF Diagnosis Enters a New Era
Conference: Brazil Cardiology Congress , June 2026
Date: June 25, 2026
Source: Medscape News
Key Points
• HFpEF now accounts for >50% of all heart failure cases and continues to increase with aging, obesity, and diabetes.
• ~80% of patients can be diagnosed using clinical assessment, natriuretic biomarkers, and echocardiography without invasive testing.
• HFA-PEFF score and left atrial (LA) strain further improve diagnostic accuracy, while exercise invasive hemodynamics remains the gold standard only for selected “gray-zone” cases.
• H₂FPEF score (0–9 points) helps estimate the probability of HFpEF:
* Heavy (BMI >30) = 2
* Hypertensive (≥2 BP drugs) = 1
* Atrial fibrillation = 3
* Pulmonary hypertension = 1
* Elder (>60 years) = 1
* Elevated filling pressure (E/e′ >9) = 1
Where 2–5: Intermediate probability → further evaluation
• SGLT2 inhibitors remain the cornerstone therapy.
• GLP-1 receptor agonists and tirzepatide mainly benefit obesity-related HFpEF.
• Finerenone (nonsteroidal MRA) has emerged as an additional option to reduce heart failure events in symptomatic HFmrEF/HFpEF patients, particularly those with lower-range EF closer to HFmrEF, with renal function and potassium monitoring.
Take-home message: HFpEF is no longer managed as a single disease. Diagnosis has become simpler, and treatment is increasingly personalized according to the patient’s phenotype.
Link:
https://www.medscape.com/viewarticle/hfpef-diagnosis-enters-new-era-2026a1000ln3
