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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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Untangling the pathophysiologic link between coronary microvascular dysfunction and heart failure with preserved
Aish Sinha1, Haseeb Rahman1, Andrew Webb1
1British Heart Foundation Centre of Excellence and National Institute for Health Research Biomedical Research Centre at the School of Cardiovascular Medicine and Sciences, King's College London, St. Thomas' Hospital, Westminster bridge road, London SE1 7EH, UK.
European Heart Journal
|September 16, 2021
Summary
Coronary microvascular disease (CMD) impairs blood flow in the heart, often seen in stable angina and heart failure with preserved ejection fraction (HFpEF). Understanding the CMD-HFpEF link is key to developing new treatments.
Area of Science:
- Cardiology
- Cardiovascular Physiology
Background:
- Coronary microvascular disease (CMD), marked by reduced coronary flow reserve (CFR), is prevalent in stable angina.
- Impaired CFR without obstructive coronary artery disease affects up to 75% of heart failure with preserved ejection fraction (HFpEF) patients.
- HFpEF is a syndrome with diverse endotypes, and CMD is hypothesized to be central to the CMD-HFpEF endotype.
Purpose of the Study:
- To review the pathophysiology of CMD.
- To explore the mechanistic link between CMD and HFpEF.
- To discuss clinical and research implications of the CMD-HFpEF connection.
Main Methods:
- Literature review focusing on CMD pathophysiology.
- Analysis of the mechanistic link between CMD and HFpEF.
- Discussion of subendocardial ischemia and impaired lusitropy in CMD-HFpEF.
Main Results:
- Subendocardial ischemia and impaired lusitropy are central to CMD-HFpEF development.
- CMD is a key factor in a specific HFpEF endotype.
- The CMD-HFpEF link has significant clinical and research implications.
Conclusions:
- CMD plays a crucial role in the pathogenesis of the CMD-HFpEF endotype.
- Further research and prospective studies are needed to understand CMD and HFpEF.
- Physiology-stratified therapies targeting CMD-HFpEF could improve patient outcomes and quality of life.
Keywords:
Coronary flow reserveCoronary microvascular diseaseHeart failure with preserved ejection fractionLusitropySubendocardial ischaemiaMore Related Videos
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