OBJECTIVE To quantify differences in the diagnosis and treatment of heart failure with preserved ejection fraction (HFpEF) between cardiologists and noncardiologists, who often diagnose and manage HFpEF. METHODS Cardiologists and noncardiologists (internal medicine, medicine/pediatrics, family medicine, geriatrics) were anonymously surveyed between January 16, 2018, and March 2, 2018, regarding practices related to diagnosing and managing HFpEF at the University of Michigan and Weill Cornell Medical Center. Response data were compared using χ2 analysis. RESULTS Of 1010 physicians surveyed, 211 completed a significant portion of the survey: 32 cardiologists and 179 noncardiologists. Most noncardiologists were unaware of HFpEF diagnostic guidelines and commonly used left ventricular diastolic dysfunction and natriuretic peptides to diagnose HFpEF. Noncardiologists (32.3%, n=52) were less likely than cardiologists (64.5%, n= 20) to prescribe an aldosterone antagonist for HFpEF (P=.001). Both groups reported similar use of β-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and exercise programs. Noncardiologists were more likely to refer patients with HFrEF to cardiology (63.1%, n=111) compared with patients with HFpEF (33.5%, n=59; P<.001). Noncardiologists were more likely to discuss prognosis and goals of care with patients with HFrEF (84.4%, n=151) than with patients with HFpEF (65.9%, n=118; P<.001). CONCLUSION Cardiologists and noncardiologists vary significantly in their HFpEF diagnosis and treatment practices. As diagnostic criteria continue to be evaluated for HFpEF, dissemination of these guidelines to noncardiologists, with an emphasis on the morbidity and mortality associated with HFpEF, is imperative.

中文翻译：

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保留射血分数可用于诊断和管理心力衰竭的基于专业的变异性。

目的量化经常诊断和治疗HFpEF的心脏病专家和非心脏病专家在保留射血分数（HFpEF）的心力衰竭诊断和治疗中的差异。方法在2018年1月16日至2018年3月2日之间，匿名调查了心脏病专家和非心脏病专家（内科，医学/儿科，家庭医学，老年医学）关于密歇根大学和威尔·康奈尔医学中心诊断和管理HFpEF的相关做法。使用χ2分析比较响应数据。结果在接受调查的1010位医生中，有211位完成了调查的重要部分：32位心脏病专家和179位非心脏病专家。大多数非心脏科医师并不了解HFpEF的诊断指南，并且通常使用左心室舒张功能障碍和利钠肽来诊断HFpEF。与心脏病专家（64.5％，n = 20）相比，非心脏病专家（32.3％，n = 52）对醛固酮拮抗剂（HFpEF）开处方的可能性更低（P = .001）。两组均报告了类似用途的β受体阻滞剂，血管紧张素转化酶抑制剂/血管紧张素受体阻滞剂和运动计划。与HFpEF患者（33.5％，n = 59； P <.001）相比，非心脏病专家更倾向于将HFrEF患者转诊至心脏病学（63.1％，n = 111）。与HFpEF患者（65.9％，n = 118； P <.001）相比，HFrEF患者（84.4％，n = 151）更倾向于讨论非心脏病专家的预后和护理目标。结论心脏科医师和非心脏科医师在HFpEF诊断和治疗方法上有很大差异。随着继续评估HFpEF的诊断标准，将这些指南传播给非心脏病专家，