Adult Echocardiography Practice Exam

What is the most common cause of heart failure with preserved ejection fraction?

1. myocardial infarction

2. hypertension

3. valvular heart disease

4. idiopathic dilated cardiomyopathy

The correct answer is: hypertension

Heart failure with preserved ejection fraction (HFpEF) is characterized by the heart's inability to properly fill with blood, despite the ejection fraction remaining within the normal range (typically defined as 50% or higher). One of the most significant contributors to the development of HFpEF is hypertension. Chronic high blood pressure leads to increased workload on the heart, which results in left ventricular hypertrophy (LVH) as the heart tries to compensate for the increased demands. Over time, this hypertrophy can disrupt normal diastolic function, leading to impaired relaxation and filling of the left ventricle during diastole. This mechanism is central to the pathophysiology of HFpEF, where the heart is structurally altered due to the pressures imposed by hypertension. The other potential causes, such as myocardial infarction, valvular heart disease, and idiopathic dilated cardiomyopathy, are often associated with heart failure with reduced ejection fraction (HFrEF) or can contribute to heart failure in a more general sense, but they are not as commonly linked with HFpEF as hypertension. High blood pressure stands out as the predominant factor in the rising prevalence of HFpEF, particularly in populations that are aging