Could Modification of Titin Contribute to an Answer for HFpEF?
Treatment of Heart Failure With Preserved Ejection Fraction: An Unmet Need In 2016, treatment of heart failure with preserved ejection fraction (HFpEF) remains a critical unmet need. A recent guideline publication (1) stated: "No treatment has yet been shown, convincingly, to reduce morbidity or mortality in patients with HFpEF." This fact stands in stark contrast to the disease burden borne by HFpEF patients (2): It is estimated that > 50% of all HF patients have HFpEF; 5 year mortality is > 60%; 6 month re-hospitalization rate for decompensated HFpEF > 50%; many patients have profound disability, often comparable to patients with reduced EF (HFrEF) who are candidates for transplantation. A recent opinion paper by Shah et al (3) discussed phenotypic diversity in the HFpEF population and proposed an approach to treatment based on specific aspects of pathophysiology present in individual patients. The accompanying paper by Methawasin et al (4), with its focus on titin, is an example of how such an approach might ultimately work.
- Received June 29, 2016.
- Revision received July 11, 2016.
- Accepted July 27, 2016.