Why the study?
HFpEF is a heterogeneous syndrome requiring personalized treatments, making it necessary to review established evidence, recent insights, and challenges in its pathophysiology using imaging-based evaluations.
This review emphasizes the critical role of multimodality imaging in understanding the complex, heterogeneous pathophysiology of HFpEF beyond left ventricular dysfunction.
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Multimodality imaging may enhance HFpEF phenotyping beyond LV dysfunction; leaves open prospective validation of therapeutic targeting.
Understanding of the pathophysiology of heart failure with preserved ejection fraction (HFpEF) has advanced rapidly over the past two decades. Currently, HFpEF is recognized as a heterogeneous syndrome, and there is a growing movement towards developing personalized treatments based on phenotype-guided strategies. Left ventricular dysfunction is a fundamental pathophysiological abnormality in HFpEF; however, recent evidence also highlights significant roles for the atria, right ventricle, pericardium, and extracardiac contributors. Imaging plays a central role in characterizing these complex and highly integrated domains of pathophysiology. This review focuses on established evidence, recent insights, and the challenges that need to be addressed concerning the pathophysiology of HFpEF, with a focus on imaging-based evaluations and opportunities for further research.
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Harada et al. (2024) studied this question.
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