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Heart failure with preserved ejection fraction (HFpEF) is highly prevalent in adults with congenital heart disease (ACHD), affecting 13% of patients regardless of ACHD severity. Patients with HFpEF are older, with more comorbidities such as diabetes, obesity, and atrial fibrillation, and experience significantly higher cardiovascular hospitalization rates. Despite these risks, diagnosis rates are low, and use of guideline-recommended therapies like sodium-glucose cotransporter 2 (SGLT2) inhibitors remains limited.
