Figure 1. Contributors to diagnostic dilemma of HFpEF and summary of diagnostic tools.
We place HFpEF diagnosis within the context of the natural history of the disease (panel A). We recognize limited understanding with respect to factors driving progression of cardiac remodeling and extracardiac involvement (panels B and C). Broadly, we propose to categorize individuals with HFpEF into non-hospitalized individuals with exercise intolerance vs hospitalized individuals with rest congestion in order to examine relevant diagnostic tools and approaches (panel D and E). Central to this conceptual framework is the recognition of major current knowledge gaps (right-hand side of figure).