The Challenge of HFpEF Diagnosis in Brazil

Heart failure with preserved ejection fraction (HFpEF) is highly prevalent in Brazil and worldwide. However, the recent diagnostic criteria for this condition are complex and difficult to apply in the Brazilian health system. This review proposes adapting the modern diagnostic criteria to the needs of each patient, from the primary care to the most complex one, using a system of three steps of complexity and highlighting the importance of searching specific disease etiology. Heart failure with preserved ejection fraction (HFpEF) remains a major public health problem worldwide and also in Brazil. 1 The recognition and diagnosis of this syndrome remain a challenge, due to its physiopathological complexity and phenotypic diversity. The current scientific evidence on etiopathogenesis provided more accurate diagnostic recommendations but requires comprehensive echocardiographic analysis. 2,3 A recently published recommendation from the Heart Failure Association of the European Society of Cardiology (HFA-ESC) brought a comprehensive overview and an algorithm for the diagnosis of HFpEF. 4