Heart failure with preserved ejection fraction (HFpEF) has grown to become the dominant form of heart failure worldwide, in tandem with ageing of the general population and the increasing prevalences of obesity, diabetes mellitus and hypertension. The clinical syndrome of HFpEF is heterogeneous and must be distinguished from heart failure with reduced ejection fraction as well as other aetiologies that have different treatment strategies. The diagnosis of HFpEF is challenging and ultimately relates to the conceptual definition of heart failure as a clinical syndrome characterized by symptoms that are associated with a reduced capacity of the heart to pump blood adequately at normal filling pressures during diastole. Clinical trials to date have been largely unsuccessful in identifying effective treatments for HFpEF but evidence supports the use of diuretics, mineralocorticoid antagonists and lifestyle interventions. Pathophysiological heterogeneity in the presentation of HFpEF is substantial, and ongoing studies are underway to evaluate the optimal methods to classify patients into phenotypically homogeneous subpopulations to facilitate better individualization of treatment.

随着一般人群的衰老以及肥胖，糖尿病和高血压的流行，具有射血分数保留的心力衰竭已发展成为全世界心力衰竭的主要形式。HFpEF的临床综合征是异质的，必须与射血分数降低的心力衰竭以及具有不同治疗策略的其他病因区分开。HFpEF的诊断具有挑战性，最终与心力衰竭的概念定义有关，后者是一种临床综合征，其特征在于症状与舒张期正常充盈压力下心脏充分抽血的能力降低有关。迄今为止，临床试验在确定HFpEF的有效治疗方面还很不成功，但有证据支持利尿剂，盐皮质激素拮抗剂和生活方式干预的使用。HFpEF表现形式的病理生理学异质性非常重要，正在进行的研究正在进行中，以评估将患者分类为表型同质亚群以促进更好的个体化治疗的最佳方法。