Key result
Neurohormonal modulation and interventions targeting systemic inflammation have yielded neutral findings in randomized trials of heart failure with preserved ejection fraction.
Why the study?
Randomized trials of neurohormonal modulation and therapies targeting systemic inflammation-induced microvascular endothelial dysfunction have been neutral in heart failure with preserved ejection fraction, warranting a review of these trials and their limitations.
Answers are grounded in this paper and cite their sources.
This review highlights the neutral outcomes of neurohormonal modulation in HFpEF and discusses the leading hypothesis of systemic inflammation-induced microvascular endothelial dysfunction.
The findings of randomized trials of neurohormonal modulation have been neutral in heart failure with preserved ejection fraction and consistently positive in heart failure with reduced ejection. Left ventricular remodeling promotes the development and progression of heart failure with preserved and reduced ejection fraction. However, different stimuli mediate left ventricular remodeling that is commonly concentric in heart failure with preserved ejection fraction and eccentric in heart failure with reduced ejection. The stimuli that promote concentric left ventricular remodeling may account for the neutral findings of neuhormonal modulation in heart failure with preserved ejection fraction. Low-grade systemic inflammation-induced microvascular endothelial dysfunction is currently the leading hypothesis behind the development and progression of heart failure with preserved ejection fraction. The hypothesis provided the rationale for several randomized controlled trials that have led to neutral findings. The trials and their limitations are reviewed.
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Samson et al. (2021) conducted a review in Heart failure with preserved ejection fraction. Neurohormonal modulation was evaluated. Neurohormonal modulation and interventions targeting systemic inflammation have yielded neutral findings in randomized trials of heart failure with preserved ejection fraction.
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