More than 50% of patients who are diagnosed with heart failure have preserved ejection fraction (HFpEF), and they have an equally poor prognosis when compared to patients with heart failure with reduced ejection fraction (HFrEF). However, a comprehensive understanding and awareness of heart failure with preserved ejection fraction is still limited and there are currently no optimized treatments to improve morbidity and mortality in these patients. This review summarizes the differences in the epidemiology, pathophysiology, diagnosis, and prognosis between HFpEF and HFrEF. We also review current management strategies of HFpEF patients according to evidence-based treatment guidelines.
Diagnosis ; Epidemiology ; Heart Failure* ; Heart Failure, Diastolic ; Humans ; Mortality ; Prognosis

The prevalence of heart failure (HF) is skyrocketing worldwide, and is closely associated with serious morbidity and mortality. In particular, HF is one of the main causes for the hospitalization and mortality in elderly individuals. Korea also has these epidemiological problems, and HF is responsible for huge socioeconomic burden. However, there has been no clinical guideline for HF management in Korea. 
The present guideline provides the first set of practical guidelines for the management of HF in Korea and was developed using the guideline adaptation process while including as many data from Korean studies as possible. The scope of the present guideline includes the definition, diagnosis, and treatment of chronic HF with reduced/preserved ejection fraction of various etiologies.
Aged ; Diagnosis* ; Heart Failure* ; Heart* ; Hospitalization ; Humans ; Korea ; Mortality ; Prevalence

Acute heart failure is a common complication of chronic heart failure and is associated with a high risk for subsequent mortality and morbidity. In 90% of case acute heart failure is the resultant of congestion, a manifestation of fluid build-up due to increased filling pressures. As residual congestion at discharge following an acute heart failure episodes is one of the strongest predictors of poor outcome, the goal of therapy should be to resolve congestion completely. Important to comprehend is that increased cardiovascular filling pressures are not solely the resultant of intravascular volume excess but can also be induced by a decreased venous capacitance. This review article focusses on the pathophysiology, diagnoses, and treatment of congestion in acute heart failure. A clear distinction is made between states of volume overload (intravascular volume excess) or volume redistribution (decreased venous capacitance) contributing to congestion in acute heart failure.
Diagnosis ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart* ; Mortality

The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute HF represent distinct disease entities. Here, we introduce the Korean guidelines for the management of acute HF with reduced or preserved ejection fraction. Part II of this guideline covers the treatment of acute HF.
Aging ; Diagnosis ; Heart Failure ; Heart ; Humans ; Mass Screening ; Mortality ; Prevalence

The prevalence of heart failure (HF) has been steadily increasing and it now creates an enormous social and economic burden. HF is a syndrome characterized by a high mortality rate, frequent hospitalization, a reduced quality of life, and a complex therapeutic regimen. In the last three decades, major progress in both the diagnosis and management of HF has taken place, and the pharmacologic and non-pharmacologic advances have led to a significant improvement in survival and symptoms in HF patients. After an accurate diagnosis, a proper HF management plan requires a multi-level team approach comprised of the correct combination of drug therapy, device therapy, and surgery, including heart transplantation. In this review, we focused on the pharmacologic and non-pharmacologic treatment strategies for HF with reduced ejection fraction. The goal was to develop treatment guidelines based on significant evidence derived from large clinical trials.
Diagnosis ; Drug Therapy ; Heart Failure* ; Heart Failure, Systolic ; Heart Transplantation ; Hospitalization ; Humans ; Mortality ; Prevalence ; Quality of Life

BACKGROUNDS AND OBJECTIVES: Anemia could adversely affect the cardiovascular condition of the patients suffering with heart failure. This study aimed to elucidate the relationship between anemia and the prognosis of heart failure (HF). SUBJECTS AND METHODS: We enrolled the patients with a diagnosis of CHF who visited to our hospital from January 2000 and January 2001 and they had a left ventricular ejection fraction (EF) less than 40% and a left ventricular end diastolic dimension (LVEDd) larger than 5.7 cm. The hemoglobin (Hb) level was accessed at the time of the initial evaluation. The patients were divided into quartiles of Hb: Hb <11.4; Hb 11.4-13.1; Hb 13.2-14.8; Hb>14.8 g/dL. RESULTS: A total of 110 patients were enrolled; there were 71 men and 39 women. Anemia was found in 39 (35.5%) patients, and this was significantly more common in the women than in men (p=0.038). The lowest Hb group was more likely to be older and female, and they had severe symptoms (NYHA functional class III or IV), a lower diastolic BP and a wider QRS width. The total mortality was 24.5%. Mortality was higher with lower Hb quartile (46.2%, 28.6%, 17.9% and 7.1% for each quartile, respectively, p=0.002). On the multivariate analysis after adjusting for age, gender, NYHA functional class and the known HF prognostic factors, the lowest Hb level proved to be an independent predictor of mortality (p=0.019). CONCLUSION: In patients with congestive heart failure, anemia is relatively common and the mortality was higher for the lower Hb group. Anemia is an independent negative prognostic factor in patients with congestive heart failure.
Anemia* ; Diagnosis ; Female ; Heart Failure* ; Heart* ; Humans ; Male ; Mortality* ; Multivariate Analysis ; Prognosis ; Stroke Volume

The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic HF were introduced in March 2016. However, chronic and acute heart failure (AHF) represent distinct disease entities. Here, we introduce the Korean guidelines for the management of AHF with reduced or preserved ejection fraction. Part I of this guideline covers the definition, epidemiology, and diagnosis of AHF.
Aging ; Diagnosis ; Epidemiology ; Heart Failure ; Heart ; Humans ; Mass Screening ; Mortality ; Prevalence

The prevalence of heart failure (HF) is on the rise due to the aging of society. Furthermore, the continuous progress and widespread adoption of screening and diagnostic strategies have led to an increase in the detection rate of HF, effectively increasing the number of patients requiring monitoring and treatment. Because HF is associated with substantial rates of mortality and morbidity, as well as high socioeconomic burden, there is an increasing need for developing specific guidelines for HF management. The Korean guidelines for the diagnosis and management of chronic heart failure (CHF) were introduced in March 2016. However, CHF and acute heart failure (AHF) represent distinct disease entities. Here, we introduce the Korean guidelines for the management of AHF with reduced or preserved ejection fraction. Part III of this guideline covers management strategies optimized according to the etiology of AHF and the presence of co-morbidities.
Aging ; Comorbidity ; Diagnosis ; Heart Failure ; Heart ; Humans ; Mass Screening ; Mortality ; Prevalence

The prevalence of heart failure (HF) is rapidly increasing throughout the world, and is closely associated with serious morbidity and mortality. In particular, acute HF is one of the main causes of hospitalization and mortality, especially in elderly individuals. In Korea, the socioeconomic burden of HF is substantial. Because of this, the Korean HF society developed chronic and acute HF management guidelines in 2017, adapted process while including as much data from Korean studies as possible. The scope of the current review, which is based on the Korean HF guidelines, includes the definition, diagnosis, and treatment of acute HF with reduced or preserved ejection fractions of various etiologies.
Aged ; Diagnosis ; Heart Failure ; Heart ; Hospitalization ; Humans ; Korea ; Medication Therapy Management ; Mortality ; Prevalence

Idiopathic pulmonary arterial hypertension (previous primary pulmonary hypertension) was a progressive disease with high mortality. Many patients with idiopathic pulmonary arterial hypertension did not show vasoreactivity, rapidly resulted in marked disability, right heart failure and death. Recent advances of therapeutic modalities have revolutionized the treatment of idiopathic pulmonary arterial hypertension. Irrespective of pulmonary arterial vasoreactivity, new vasodilatng agents, such as epoprostenol, treprostinil, iloprost, bosentan, and sildenafil, significantly improved hemodynamics, symptoms, exercise capacities, quality of life, and survival. The median survival of patients with idiopathic pulmonary arterial hypertension has been prolonged from 2.8 years to more than 5 years. In a near future, pulmonary arterial hypertension could be easily controlled like a systemic arterial hypertension.
Diagnosis* ; Epoprostenol ; Heart Failure ; Hemodynamics ; Humans ; Hypertension* ; Iloprost ; Mortality ; Quality of Life ; Sildenafil Citrate