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hello im going to speak about heart failure with the preserved ejection fraction an entity formerly known as diastolic heart failure and im going to try to speak if it is a myth or reality as exemplified by the emperor preserve trial the emperor trial was a trial that was published in the new england in october fourteenth twenty twenty one in this trial they picked up almost 6 000 patients with heart failure clinically on a class 2 to 4 and an ejection fraction above 40 percent and they were divided and randomized to receive either amp glyphosene 10 milligrams once daily or placebo in addition to usual therapy they were followed for a median of 26 months over two years and the primary outcome was a composite of cardiovascular death or hospitalization for heart failure and after over two years this primary outcome happened in 17.1 percent of placebo patients and 13.8 percent of imperglifusing patients uh absolute reduction of 3.3 or a relative reduction of 21 as in the table in the h