HFpEF Diagnosis Enters a New Era<\/p>\n
Conference: Brazil Cardiology Congress , June 2026<\/p>\n
Date: June 25, 2026<\/p>\n
Source: Medscape News<\/p>\n
Key Points<\/p>\n
\u2022\u2060 \u2060HFpEF now accounts for >50% of all heart failure cases and continues to increase with aging, obesity, and diabetes.
\n\u2022\u2060 \u2060~80% of patients can be diagnosed using clinical assessment, natriuretic biomarkers, and echocardiography without invasive testing.
\n\u2022\u2060 \u2060HFA-PEFF score and left atrial (LA) strain further improve diagnostic accuracy, while exercise invasive hemodynamics remains the gold standard only for selected \u201cgray-zone\u201d cases.
\n\u2022\u2060 \u2060H\u2082FPEF score (0\u20139 points) helps estimate the probability of HFpEF:
\n* Heavy (BMI >30) = 2
\n* Hypertensive (\u22652 BP drugs) = 1
\n* Atrial fibrillation = 3
\n* Pulmonary hypertension = 1
\n* Elder (>60 years) = 1
\n* Elevated filling pressure (E\/e\u2032 >9) = 1
\nWhere 2\u20135: Intermediate probability \u2192 further evaluation
\n\u2022\u2060 \u2060SGLT2 inhibitors remain the cornerstone therapy.
\n\u2022\u2060 \u2060GLP-1 receptor agonists and tirzepatide mainly benefit obesity-related HFpEF.
\n\u2022\u2060 \u2060Finerenone (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.<\/p>\n
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\u2019s phenotype.<\/p>\n