What question did this study set out to answer?

To review the multi-chamber structural abnormalities, molecular mechanisms, diagnostic criteria, and therapeutic challenges in heart failure with preserved ejection fraction (HFpEF).

July 22, 2020Cardiovascular Research

Heart failure with preserved ejection fraction: insights into diagnosis and pathophysiology

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To review the multi-chamber structural abnormalities, molecular mechanisms, diagnostic criteria, and therapeutic challenges in heart failure with preserved ejection fraction (HFpEF).
Literature review of clinical and experimental evidence on structural remodeling across all four heart chambers using invasive and noninvasive modalities.
Evaluation of molecular drivers of myocardial stiffness, including titin phosphorylation, cyclic guanosine monophosphate signaling, calcium handling, and the unfolded protein response.
Assessment of diagnostic frameworks, focusing on the echocardiographic parameters, natriuretic peptides, and algorithms including H2FPEF and HFA-PEFF.
HFpEF manifests through all four cardiac chambers, causing left ventricular diastolic and systolic dysfunction, left atrial enlargement, pulmonary hypertension, and right ventricular hypertrophy.
Myocardial stiffness is driven by titin hypophosphorylation, interstitial fibrosis, reduced cyclic guanosine monophosphate from systemic inflammation, and defective unfolded protein responses.
Diagnostic protocols rely on echocardiography, elevated natriuretic peptides, and resting or exercise wedge pressure measurements via H2FPEF or HFA-PEFF, though disease-specific therapies remain scarce.

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Implication

Supports HFpEF diagnosis via H2FPEF/HFA-PEFF; leaves open prospective validation of algorithms.

Cite This Study

Sherif F. Nagueh (2020) studied this question.

synapsesocial.com/papers/69cff87247485ca0e310d8a9 https://doi.org/10.1093/cvr/cvaa228

Topics

Echocardiography HFpEF management

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Heart failure with preserved ejection fraction: insights into diagnosis and pathophysiology

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Heart failure with preserved ejection fraction: insights into diagnosis and pathophysiology

Key Points

Discussion

Implication

Cite This Study

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