Clinical question of the week - do you really believe in heart failure with reserved ejection fraction?

I was talking to a colleague this week about an 80 year old lady with a resting heart rate of 55bpm who had been diagnosed with heart failure with preserved (normal) ejection fraction. His comment was '' well I always question myself when I make this diagnosis, because you know'..." I can see his point - the diagnostic criteria vary. For example NICE criteria require the clinical syndrome of heart failure but not any imaging changes whereas the ESC criteria require some imaging change eg left atrial dilation or left ventricular hypertrophy. Do you really believe in this entity?
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums