Article
Peripheral Vascular Disease
Michael A. Francisco, Joshua F. Lee, Zachary Barrett-O'Keefe, H. Jonathan Groot, Stephen M. Ratchford, Kanokwan Bunsawat, Jeremy K. Alpenglow, John J. Ryan, Jose N. Nativi, Russell S. Richardson, D. Walter Wray
Summary: The study revealed a significant decline in lower limb microvascular function in patients with HFpEF compared to healthy controls, possibly associated with systemic inflammation and oxidative damage. However, disease-related biomarkers of inflammation and oxidative damage were not correlated with responses to passive leg movement.
Letter
Medicine, General & Internal
Elric Zweck, Ralf Westenfeld, Bjorn Redfors, Elmir Omerovic, Robin A. P. Weir, Domenico Gabrielli, Fabrizio Oliva, Giuseppe Zuccala, Scott D. Solomon, Muthiah Vaduganathan, John J. V. McMurray
Summary: Solomon et al. report on the DELIVER trial, which showed that dapagliflozin reduced risks of heart failure-related outcomes in patients with a mildly reduced or preserved left ventricular ejection fraction. These findings are expected to influence guidelines and clinical practice. The trial also confirmed dapagliflozin's efficacy in patients with a left ventricular ejection fraction of 60% or above.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Letter
Medicine, General & Internal
Debdatta Bhattacharyya, Ayan Kar, Saurabh Dhumale, Filippos K. Triposkiadis, Andrew Xanthopoulos, Efstathios K. Iliodromitis, James Amato, Hiddo J. L. Heerspink, Lesley Inker, Tom Greene, Stefan D. Anker, Javed Butler, Milton Packer
Summary: In patients with heart failure and preserved ejection fraction, Empagliflozin reduced the incidence of primary outcome events compared to other drugs, but had higher rates of cardiovascular death, death from any cause, and hospitalization for heart failure compared to spironolactone.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Sebastian Rosch, Karl-Patrik Kresoja, Christian Besler, Karl Fengler, Anne Rebecca Schoeber, Maximilian von Roeder, Christian Luecke, Matthias Gutberlet, Karin Klingel, Holger Thiele, Karl-Philipp Rommel, Philipp Lurz
Summary: In this study, patients with heart failure with preserved ejection fraction (HFpEF) were stratified based on left ventricular ejection fraction (LVEF), resulting in distinct morphologic and pathophysiologic subphenotypes. Patients with LVEF ranging from 50% to 60% demonstrated reduced contractility, impaired ventriculo-arterial coupling, and higher extracellular volume fraction, while patients with LVEF >60% exhibited a hypercontractile state with excessive left ventricular afterload and diminished preload reserve.
Article
Cardiac & Cardiovascular Systems
Walter J. Paulus, Michael R. Zile
Summary: According to the comorbidity-inflammation paradigm, comorbidities, especially metabolic ones, are believed to drive the development and severity of heart failure with preserved ejection fraction. Recent evidence includes myocardial infiltration, inducible nitric oxide synthase expression, patient phenogroups, and direct connections between comorbidities, inflammatory biomarkers, and abnormal myocardial structure/function.
CIRCULATION RESEARCH
(2021)
Review
Cardiac & Cardiovascular Systems
Barry A. Borlaug, Michael D. Jensen, Dalane W. Kitzman, Carolyn S. P. Lam, Masaru Obokata, Oliver J. Rider
Summary: Obesity and heart failure with preserved ejection fraction (HFpEF) are two intertwining epidemics, and obesity may have widespread effects on the cardiovascular system, leading to symptomatic HFpEF. Understanding the pathophysiological mechanisms of obese HFpEF is crucial for developing new therapeutic approaches.
CARDIOVASCULAR RESEARCH
(2023)
Review
Cardiac & Cardiovascular Systems
Zhen Hui Peh, Adel Dihoum, Dana Hutton, J. Simon C. Arthur, Graham Rena, Faisel Khan, Chim C. C. Lang, Ify R. Mordi
Summary: HFpEF is a type of heart failure that accounts for around half of all cases and may become the dominant type in the future. Compared to heart failure with reduced ejection fraction, there are limited evidence-based treatment strategies available for HFpEF. Inflammation is believed to play a key role in the pathophysiology of HFpEF and could be a potential therapeutic target.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Barry A. Borlaug, Kavita Sharma, Sanjiv J. Shah, Jennifer E. Ho
Summary: The incidence and prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing due to aging, obesity, sedentariness, and cardiometabolic disorders. Despite recent advances in understanding its pathophysiological effects and introduction of new diagnosis approaches, HFpEF remains under-recognized. This is concerning as effective treatments have been identified. This article provides an in-depth examination of the epidemiology, pathophysiology, diagnosis, and treatment of HFpEF. (J Am Coll Cardiol 2023;81:1810-1834) (c) 2023 by the American College of Cardiology Foundation.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Medicine, General & Internal
Alessio Balletti, Nicolo De Biase, Lavinia Del Punta, Francesco Filidei, Silvia Armenia, Filippo Masi, Valerio Di Fiore, Matteo Mazzola, Alessandra Bacca, Frank L. Dini, Stefano Taddei, Stefano Masi, Nicola Riccardo Pugliese
Summary: This study explored various cardiometabolic patterns, including inflammatory and congestive pathways, in patients with heart failure (HF). The results showed that in HFpEF patients, glycated hemoglobin (Hb1Ac) was positively correlated with high-sensitivity C-reactive protein (hs-CRP), indicating a relationship between Hb1Ac and inflammation. In HFrEF patients, there was a correlation between Hb1Ac and norepinephrine. Additionally, Hb1Ac was found to be associated with congestion in HFpEF patients, while a significant relationship between congestion and inflammation was observed in HFrEF patients.
Article
Cardiac & Cardiovascular Systems
Dan Tong, Gabriele G. Schiattarella, Nan Jiang, Francisco Altamirano, Pamela A. Szweda, Abdallah Elnwasany, Dong I. Lee, Heesoo Yoo, David A. Kass, Luke I. Szweda, Sergio Lavandero, Eric Verdin, Thomas G. Gillette, Joseph A. Hill
Summary: The study demonstrated through a mouse model that HFpEF is associated with myocardial mitochondrial dysfunction, and NAD(+) supplementation is considered a promising therapeutic approach.
CIRCULATION RESEARCH
(2021)
Review
Cardiac & Cardiovascular Systems
Francesca Graziani, Rosa Lillo, Filippo Crea
Summary: HFpEF is a significant public health issue with a lack of effective treatment. A new paradigm suggests that coexisting cardiovascular and non-cardiovascular comorbidities may lead to systemic inflammation, potentially resulting in myocardial fibrosis. Anti-fibrotic and anti-inflammatory drugs may play a role in treating HFpEF.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Review
Cell Biology
Thassio Mesquita, Yen-Nien Lin, Ahmed Ibrahim
Summary: HFpEF is the predominant form of heart failure with a significant increase in risk with age. Low-grade inflammation, termed inflammaging, is a common feature of HFpEF pathology. Suppression of proinflammatory pathways has been associated with attenuated disease severity and improved outcomes in HFpEF. Inflammasome signaling plays a central role in mediating chronic inflammation and cardiovascular disease progression.
Article
Cardiac & Cardiovascular Systems
Thassio Mesquita, Rui Zhang, Jae Hyung Cho, Rui Zhang, Yen-Nien Lin, Lizbeth Sanchez, Joshua Goldhaber, Joseph K. Yu, Jialiu A. Liang, Weixin Liu, Natalia A. Trayanova, Eugenio Cingolani
Summary: Chronotropic incompetence and sinoatrial node (SAN) dysfunction are common problems in patients with heart failure, but the underlying mechanisms are not yet fully understood. This study identified intrinsic abnormalities in SAN structure and function as the cause of chronotropic incompetence in heart failure patients with preserved ejection fraction (HFpEF).
Article
Cardiac & Cardiovascular Systems
Jin Joo Park, Minjae Yoon, Hyoung-Won Cho, Hyun-Jai Cho, Kye Hun Kim, Dong Heon Yang, Byung-Su Yoo, Seok-Min Kang, Sang Hong Baek, Eun-Seok Jeon, Jae-Joong Kim, Myeong-Chan Cho, Shung Chull Chae, Byung-Hee Oh, Dong-Ju Choi
Summary: This study investigated the prognostic value of C-reactive protein (CRP) and statins in heart failure patients. The results showed a positive correlation between CRP levels and in-hospital and post-discharge mortality. Patients using statins had a better survival trend in the highest CRP level group.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Jesse D. Cochran, Yoshimitsu Yura, Mark C. Thel, Heather Doviak, Ariel H. Polizio, Yuka Arai, Yohei Arai, Keita Horitani, Eunbee Park, Nicholas W. Chavkin, Anupreet Kour, Soichi Sano, Nitin Mahajan, Megan Evans, Mahalia Huba, Nadia Martinez Naya, Hanna Sun, Young Ho Ban, Karen K. Hirschi, Stefano Toldo, Antonio Abbate, Todd E. Druley, Frederick L. Ruberg, Mathew S. Maurer, Justin A. Ezekowitz, Jason R. B. Dyck, Kenneth Walsh
Summary: The study identified an enrichment of TET2-mediated CH in patients with HFpEF, which was associated with exacerbated diastolic dysfunction. Patients with HFpEF, aged >= 70 years and CH, exhibited a worse prognosis in terms of 5-year cardiovascular-related hospitalization rate compared with those without CH.
