{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:17:24Z","timestamp":1792430244759,"version":"4.5.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":370,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aims to evaluate the worldwide variations in the diagnosis and treatment of heart failure with preserved ejection fraction (HFpEF), using an HF survey distributed internationally to physicians, including both cardiologists and non-cardiologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A group of HF specialists designed an independent, academic web-based survey focusing on HFpEF care and diagnosis, which was distributed via scientific societies and various social networks between 1 May 2023 and 1 July 2023. The survey included 1459 physicians (1242 cardiologists and 217 non-cardiologists) from 91 countries, with a mean age of 42 (34\u201349) years and 61% male. Most physicians (89.2%) defined HFpEF as left ventricular ejection fraction \u226550%. Significant regional variations were observed in HFpEF management (P &amp;lt; 0.001 for all comparisons unless stated otherwise). Cardiologists managed 63.1% of HFpEF patients overall, with significant variability across regions (P &amp;lt; 0.001). The estimated HFpEF prevalence was highest in Eastern Asia and Western Europe and lowest in Africa and South America. Diagnostic practices varied: natriuretic peptide use ranged from 70%\u201374% in Africa to 95%\u201397% in Southern\/Western Europe. Echocardiographic parameters showed regional differences, with diastolic stress testing used most in South-Eastern Asia (47% vs. 13\u201336% elsewhere). HFpEF scoring systems were most common in South-Eastern Asia (78%) and least in Africa (30.1%). Coronary artery disease screening approaches differed, with Eastern Asian physicians more likely to always perform routine angiograms (52%) compared with Northern Europeans (12%). Treatment preferences also varied regionally. Sodium glucose co-transporter-2 inhibitors (SGLT2i) was the preferred first-line treatment (45%\u201370% across regions), followed by diuretics. In an ideal setting, 52% would primarily use SGLT2i, 33% loop diuretics, and 22% beta-blockers. Drug availability differed significantly: SGLT2i was most available (88% overall), while ARNI was least available (61%). South America and Middle Eastern\/Northern Africa reported lower availability of guideline-directed therapies. Multidisciplinary HF programmes were most common in Asia (70%) and least in Africa (24%). The perceived benefit of atrial flow regulator devices also showed significant regional differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are considerable global variations in the diagnosis and management of HFpEF. Most physicians favour SGLT2i despite regional disparities in health care resources and guideline adherence. Harmonized practices and improved access to comprehensive care can enhance outcomes of HFpEF patients worldwide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.15084","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T04:39:57Z","timestamp":1727757597000},"page":"487-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diagnostic and Therapeutic Practice for HFpEF Across Continents and Regions: An International Survey"],"prefix":"10.1093","volume":"12","author":[{"given":"Inga J.","family":"Ingimarsd\u00f3ttir","sequence":"first","affiliation":[{"name":"Department of Cardiology, Landspitali University Hospital , Reykjavik ,","place":["Iceland"]},{"name":"Department of Health Sciences, Faculty of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie K.K.","family":"Vishram-Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zealand University Hospital , Roskilde ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsteinn","family":"Einarsson","sequence":"additional","affiliation":[{"name":"Department of Engineering and Natural Sciences, Faculty of Computer Science, University of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Goldfeder","sequence":"additional","affiliation":[{"name":"CardioVID \u2013 Clinic , Medell\u00edn ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Mewton","sequence":"additional","affiliation":[{"name":"Cardiology Institute of the Hospices Civils de Lyon, Heart Failure Department, Clinical Investigation Center Inserm 1407 CarMeN Inserm 1060, University Claude Bernard Lyon 1 , Lyon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Barasa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amager Hvidovre Hospital, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"The African Heart Failure Association (PASCAR) , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Basic","sequence":"additional","affiliation":[{"name":"Department of Medicine Geriatrics and Emergency Medicine\/\u00d6stra, Region V\u00e4stra G\u00f6taland, Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]},{"name":"Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marish I.F.J.","family":"Oerlemans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Utrecht , Utrecht ,","place":["The Netherlands"]},{"name":"European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart: ERN GUARD-Heart\u2019 (ERN GUARDHEART) , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Niederseer","sequence":"additional","affiliation":[{"name":"Hochgebirgsklinik Davos, Medicine Campus Davos , Davos ,","place":["Switzerland"]},{"name":"Christine K\u00fchne Center for Allergy Research and Education (CK-CARE), Medicine Campus Davos , Davos ,","place":["Switzerland"]},{"name":"Department of Cardiology, Center of Translational and Experimental Cardiology (CTEC), University Heart Center Zurich, University Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Shchendrygina","sequence":"additional","affiliation":[{"name":"Department of Hospital Therapy 2, I.M. Sechenov First Moscow State Medical University , Moscow ,","place":["Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, University of Copenhagen , Copenhagen ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Ruschitzka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Center of Translational and Experimental Cardiology (CTEC), University Heart Center Zurich, University Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]},{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Kida","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, St Marianna University School of Medicine , Kawasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dania","family":"Mohty","sequence":"additional","affiliation":[{"name":"King Faisal Specialist Hospital & Research Center, Heart Center , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolland R.","family":"Rakotonoel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Joseph Raseta Befelatanana , Antananarivo ,","place":["Madagascar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Naung","family":"Tun","sequence":"additional","affiliation":[{"name":"Larner College of Medicine, University of Vermont , Burlington, Vermont ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Th\u00f3rd\u00eds J.","family":"Hrafnkelsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Landspitali University Hospital , Reykjavik ,","place":["Iceland"]},{"name":"Department of Health Sciences, Faculty of Medicine, University of Iceland , Reykjavik ,","place":["Iceland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Saldarriaga","sequence":"additional","affiliation":[{"name":"Pontificia Bolivariana University \u2013 Antioquia\u2019s University , Medell\u00edn ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"2026012113060058500_ehf215084-bib-0001","doi-asserted-by":"publisher","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2026012113060058500_ehf215084-bib-0002","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1002\/ejhf.483","article-title":"Epidemiology of heart failure: the prevalence of heart failure and ventricular dysfunction in older adults over time. 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