Hemodynamic Assessment in Heart Failure with Preserved Ejection Fraction

Invasive CPET enables direct assessment of the hemodynamic abnormalities underlying HF and has now emerged as the gold-standard method to evaluate for the cause of unexplained dyspnea among patients with normal EF. In addition to its role for diagnosis of HFpEF, invasive exercise testing is useful to identify alternative causes of dyspnea due and may be useful to enhance patient phenotyping and to guide individualization of therapy and establish trial eligibility. With increasingly widespread use, the number of patients suffering from unexplained dyspnea has and will continue to contract, and accurate diagnosis of HFpEF will become more widespread, which is more important now than ever before given the emergence of highly effective therapies for patients with this form of HF.