Key result
Cardio-hepato-pancreas axis reframes HFpEF as a systemic disorder driven by congestion, inflammation, and metabolic dysregulation.
Reframing HFpEF as a systemic syndrome involving the heart-liver-pancreas axis suggests that management should shift from cardiac-centric strategies to targeting underlying systemic inflammation and metabolic dysregulation.
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Supports considering systemic inflammation in HFpEF; leaves open efficacy of heart-liver-pancreas interventions in trials.
Heart failure with preserved ejection fraction (HFpEF) is a complex disease that has been historically difficult to treat and manage. Novel research shifts understanding of HFpEF from a primary heart disease to a systemic syndrome driven by systemic inflammation, congestion, and multi-organ metabolic dysregulation. These three key drivers can all be integrated into the heart–liver–pancreas inflammatory axis, with bidirectional self-amplifying interactions between these organs leading to a vicious cycle with worse clinical outcomes. This paper will unravel the mechanics of this axis and provide important implications from a therapeutic standpoint, shifting the management of HFpEF from cardiac-centric strategies to interventions targeting the underlying systemic inflammation, metabolic dysregulation, and congestion.
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Tun et al. (2026) conducted a review in Heart failure with preserved ejection fraction (HFpEF). The cardio-hepato-pancreas inflammatory axis reframes heart failure with preserved ejection fraction as a systemic disorder driven by congestion, inflammation, and metabolic dysregulation.
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