recent advancements in the treatment of heart failure with preserved ejection fraction (HFpEF) -January 14, 2025.

recent advancements in the treatment of heart failure with preserved ejection fraction (HFpEF) -January 14, 2025.

Dr. Clyde Yancy, former president of the American Heart Association (AHA) and chief of cardiology at Northwestern Medicine, discussed the significant progress made in HFpEF management at the AHA 2024 meeting.

Historically, HFpEF had limited treatment options, primarily focused on symptom management. However, recent clinical trials have ushered in a “new era” of HFpEF therapy, with four major drug classes showing promising results:

1. SGLT2 inhibitors – Originally developed for diabetes, these drugs have demonstrated clear benefits in heart failure patients.

2. Mineralocorticoid receptor antagonists (MRAs) – The nonsteroidal MRA finerenone has shown potential in reducing symptoms and hospitalizations.

3. Incretin therapies – Dual incretin agonists, such as those studied in the SUMMIT trial, provide symptom relief and reduce hospitalization risk.

4. Combination approaches – A triple therapy approach now offers a structured treatment pathway for HFpEF, a significant contrast to the past when few options were available.

Despite these breakthroughs, challenges remain. No therapy has yet been proven to reduce cardiovascular mortality in HFpEF, unlike treatments for heart failure with reduced ejection fraction (HFrEF). Yancy highlighted ongoing research into inflammatory-targeted therapies and potential device-based treatments for HFpEF.

Another critical issue is underdiagnosis—many clinicians are not fully aware of HFpEF as a treatable condition. Yancy emphasized the importance of educating healthcare providers and ensuring access to new therapies despite cost and affordability challenges.

While barriers exist, these recent advancements represent a major leap forward in HFpEF treatment, with the potential to improve the lives of millions of patients worldwide.