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Updated: Mar 25, 2026
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Understanding heart failure with preserved ejection fraction: where are we today?
L van Heerebeek1,2, W J Paulus3
1Institute for Cardiovascular Research VU (ICaR-VU), VU University Medical Center Amsterdam, Amsterdam, The Netherlands. l.vanheerebeek@vumc.nl.
Summary
Heart failure with preserved ejection fraction (HFpEF) is complex, with treatments failing due to poor understanding. New insights suggest comorbidities drive HFpEF via coronary microvascular inflammation, necessitating personalized treatment approaches.
Area of Science:
- Cardiology
- Pathophysiology
- Translational Research
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a prevalent, heterogeneous syndrome with poor outcomes.
- Unlike heart failure with reduced ejection fraction (HFrEF), HFpEF lacks effective pharmacotherapy due to incomplete understanding of its pathophysiology.
- HFpEF patients are often elderly females with comorbidities that adversely affect cardiac remodeling.
Purpose of the Study:
- To review novel insights into HFpEF pathophysiology.
- To highlight the role of comorbidities and patient heterogeneity in HFpEF.
- To discuss a new paradigm of HFpEF driven by coronary microvascular inflammation.
Main Methods:
- Review of clinical and translational research on HFpEF.
- Analysis of pathophysiological processes contributing to HFpEF.
- Examination of the impact of comorbidities on myocardial dysfunction.
Main Results:
- Comorbidities are increasingly recognized as key drivers of myocardial dysfunction in HFpEF.
- Coronary microvascular inflammation is proposed as a central mechanism linking comorbidities to HFpEF.
- Patient heterogeneity and comorbidities significantly impact HFpEF development and progression.
Conclusions:
- A shift towards individualized HFpEF treatment based on patient phenotyping and pathophysiological stratification is needed.
- Understanding the role of comorbidities and inflammation is crucial for developing effective HFpEF therapies.
- Novel insights into HFpEF pathophysiology pave the way for tailored therapeutic strategies.
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