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Epigenomics and Epigenetics in Heart Failure with Preserved Ejection Fraction
1Division of Cardiology, Department of Medicine, University of British Columbia, 9th Floor 2775 Laurel Street, Vancouver, British Colombia V5Z 1M9, Canada.
Heart Failure Clinics
|March 28, 2026
Summary
Heart failure with preserved ejection fraction is complex, with subtypes driven by fibrosis, obesity, and aging. Epigenetic changes like DNA methylation and microRNAs influence these mechanisms.
Area of Science:
- Cardiology and Molecular Biology
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical syndrome.
- Multiple pathophysiologic mechanisms contribute to HFpEF, including myocardial fibrosis, obesity, metabolic disturbances, inflammation, oxidative stress, epicardial fat accumulation, and aging.
Purpose of the Study:
- To explore the role of epigenomic and epigenetic modifications in the diverse mechanisms underlying HFpEF subtypes.
Main Methods:
- Review of fundamental epigenomic and epigenetic processes.
- Analysis of how these processes impact HFpEF-related mechanisms.
Main Results:
- Epigenetic mechanisms, including DNA methylation, ATP-dependent chromatin remodeling, histone modifications (acetylation, sumoylation, O-GlcNAcylation), and microRNAs, are implicated in HFpEF pathophysiology.
- These epigenetic changes can modulate the various contributing factors to HFpEF.
Conclusions:
- Epigenetic alterations represent a crucial layer of regulation in the complex pathophysiology of heart failure with preserved ejection fraction.
- Understanding these epigenetic underpinnings may reveal novel therapeutic targets for HFpEF subtypes.
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