Abstract

Heart failure with a normal left ventricular ejection fraction (HFNEF) is a significant cause of mortality and morbidity in older people, particularly women with hypertension. This clinical syndrome remains under-recognised despite its prevalence and the long-term prognosis remains poor. HFNEF has emerged in the last 10-15 years as a distinct clinical and patho-physiological entity that has been recognised in the 2005 revised guidelines for the diagnosis and treatment of chronic heart failure, of the European Society of Cardiology, and American Heart Association/American College of Cardiology. However, there is currently no proven specific therapy for heart failure with a well-preserved left ventricular ejection fraction largely due to a lack of evidence-based information on therapeutic intervention. This review examines the clinical and physiological characteristics of HFNEF and weighs up the management options available.