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Immunomodulation in Heart Failure with Preserved Ejection Fraction: Current State and Future Perspectives
Elise L Kessler1,2,3, Martinus I F J Oerlemans3,4, Patricia van den Hoogen1,3
1Laboratory of Experimental Cardiology, Cardiology, UMC Utrecht Regenerative Medicine Center, University Medical Center Utrecht, Utrecht, Netherlands.
Journal of Cardiovascular Translational Research
|May 24, 2020
Summary
Heart failure with preserved ejection fraction (HFpEF) is a growing epidemic. Targeting inflammation and comorbidities may offer new therapeutic strategies for HFpEF patients.
Area of Science:
- Cardiology
- Immunology
- Internal Medicine
Background:
- Heart failure with preserved ejection fraction (HFpEF) affects approximately half of all heart failure patients.
- HFpEF is characterized by diastolic dysfunction and preserved left ventricular ejection fraction (LVEF ≥ 50%).
- Comorbidities like hypertension, diabetes, obesity, and renal failure contribute to systemic inflammation, impacting cardiac function in HFpEF.
Purpose of the Study:
- To provide an overview of current immunomodulatory therapies for HFpEF.
- To discuss future perspectives for treating HFpEF by targeting underlying comorbidities and inflammation.
Main Methods:
- Review of existing literature on HFpEF pathophysiology and treatment.
- Analysis of randomized trials involving traditional HF medications in HFpEF.
- Exploration of the role of inflammatory biomarkers in HFpEF.
Main Results:
- Traditional HF medications have shown limited benefits in improving hard endpoints (mortality/hospitalization) for HFpEF patients.
- Increased inflammatory biomarkers are associated with HFpEF and predict its incidence.
- HFpEF patients exhibit higher inflammatory markers compared to those with heart failure with reduced ejection fraction (HFrEF).
Conclusions:
- Standard HF therapies are insufficient for effective HFpEF management.
- Targeting underlying comorbidities and systemic inflammation presents a promising therapeutic avenue for HFpEF.
- Immunomodulatory therapies warrant further investigation for HFpEF treatment.
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