Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease in Europe through percutaneous cardiovascular interventions.
Our mission is to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
Mr Papp Zoltan
Heart failure with preserved ejection fraction (HFPEF) is a complex cardiovascular syndrome, often complicated by co-morbidities. The pathophysiological background of HFPEF has been related to a wide range of alterations of the heart and the vasculature ranging from myocardial fibrosis and increased cardiomyocyte passive stiffness to microcirculatory dysfunction. According to the 2012 ESC guidelines for the management of heart failure, the diagnosis of HFPEF requires: symptoms and signs typical of HF, normal or mildly reduced LVEF without LV dilation, and relevant structural/functional heart disease (LV hypertrophy/LA enlargement and/or diastolic dysfunction). Invasive hemodynamic indices, Doppler tissue imaging and biomarkers (e.g. BNP or NT-proBNP) are very important in this context. Moreover, new echocardiographic techniques (e.g. speckle-tracking) and exercise testing will soon also enhance the diagnosis of HFPEF. The management of HFPEF is problematic, as no therapies have been shown to improve its clinical outcomes. However, recent clinical studies on the effects of exercise training in HFPEF suggested improvements in LV diastolic function and exercise capacity. Interestingly, results of the Aldo-DHF study indicated that pharmacological inhibition of the pro-fibrotic mineralocorticoid receptors by spironolactone also improved LV diastolic function, but without alterations in exercise capacity. Moreover, data of the PARAMOUNT study suggested that combined inhibition of angiotensin-receptors and the enzyme responsible for breakdown of natriuretic peptides (by LCZ696) might be an effective approach for treating HFPEF. Finally, experimental evidence implicates modulators of the autonomic nervous system or cardiomyocyte ionic homeostasis (e.g. through ryanodine-receptor stabilization or inhibition of the late sodium current) may also hold promises for future pharmacological management in HFPEF.
"Heart failure with preserved ejection fraction; from pathophysiology to therapy"
© 2017 European Society of Cardiology. All rights reserved