Heart failure with preserved ejection fraction: Classification based upon phenotype is essential for diagnosis and treatment

Heart failure (HF) is classified based upon the left ventricular ejection fraction (LVEF). Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous disorder with increasing prevalence in the elderly that remains incompletely understood and inadequately treated as no therapy has shown favorable effects. In this review, we summarize the current theories regarding HFpEF pathogenesis, propose a phenotype-based classification of HFpEF, discuss prevention strategies, explain why clinical trials on HFpEF treatment have failed, and make suggestions for the future.