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7.6.2. HF With Improved Ejection Fraction
COR LOE
Recommendation
1 B-R 1. In HFimpEF after treatment, GDMT should be continued
to prevent relapse of HF and LV dysfunction, even in patients
who may become asymptomatic.
7.7.1. HF With Preserved Ejection Fraction*
COR LOE
Recommendations
1 C-LD 1. Patients with HFpEF and hypertension should have
medication titrated to attain blood pressure targets in
accordance with published clinical practice guidelines to
prevent morbidity.
2a B-R 2. In patients with HFpEF, SGLT2i can be beneficial in
decreasing HF hospitalizations and cardiovascular mortality.
2a C-EO 3. In patients with HFpEF, management of AF can be useful to
improve symptoms.
2b B-R 4. In selected patients with HFpEF, MRAs may be considered
to decrease hospitalizations, particularly among patients with
LVEF on the lower end of this spectrum.
2b B-R 5. In selected patients with HFpEF, the use of ARB may be
considered to decrease hospitalizations, particularly among
patients with LVEF on the lower end of this spectrum.
2b B-R 6. In selected patients with HFpEF, ARNi may be considered
to decrease hospitalizations, particularly among patients with
LVEF on the lower end of this spectrum.
3: No-
Benefit
B-R 7. In patients with HFpEF, routine use of nitrates or
phosphodiesterase-5 inhibitors to increase activity or QOL is
ineffective.
* See Section 7.2 ("Diuretics and Decongestion Strategies in Patients with HF") and Section
10.2 ("Management of Atrial Fibrillation (AF) in HF") for recommendations for use of
diuretics and management of AF in HF.
7.7. Preserved EF (HFpEF)
