Chronic heart failure with preserved ejection fraction: current understanding of the problem

This review is aimed at the investigation of diagnostic approaches and therapeutic options for patients with chronic cardiac insufficiency with preserved ejection fraction. Chronic cardiac insufficiency with preserved ejection fraction can result from various cardiovascular diseases and is observed in more than 50 % of patients with chronic circulatory failure. Although clinical guidelines exist, the criteria for diagnosing this form of heart failure do not always allow to detect the disease accurately, which can affect subsequent treatment negatively. Modern randomized clinical trials demonstrate that medications from the group of sodium-glucose cotransporter type-2 inhibitors significantly improve clinical outcomes in patients with circulatory failure, justifying their inclusion in treatment regimen. However, the optimal time for starting this therapy is still questionable compared to the administration of other medications recommended for chronic cardiac insufficiency. Considering high incidence, difficulties in diagnosis and treatment for circulatory failure with preserved ejection fraction in practice, the development of practical algorithms for detecting and managing this condition is one of the most important tasks.