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The study compared the cardiac function of patients with heart failure and preserved ejection fraction (HFpEF) with different EF ranges (HFpEF<65% and HFpEF≥65%) and found that most pathophysiologic differences were related to smaller heart size, increased left ventricular diastolic stiffness, and leftward shift in the end diastolic pressure volume relationship (EDPVR). These differences may explain the reduced efficacy of neurohormonal antagonists in patients with HFpEF and higher EF. The study suggests that interventions to stimulate eccentric LV remodeling and enhance diastolic capacitance may be beneficial for these patients.
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