Key result
Female patients with PH-HFpEF show greater vascular remodeling yet paradoxically maintain better RV function and survival.
Why the study?
Sex differences in pulmonary hypertension associated with HFpEF involve paradoxical findings of more vascular remodeling but better survival and RV function in females, warranting mechanistic investigation of the hepato-pulmonary axis.
Female patients with PH-HFpEF exhibit a paradox of more pronounced pulmonary vascular remodeling but better survival and preserved right ventricular function.
Sex differences in PH-HFpEF remodeling may refine phenotyping; leaves open prognostic and therapeutic implications pending prospective studies.
Extract Heart failure with preserved ejection fraction (HFpEF) represents a growing clinical challenge driven by an increasing prevalence of comorbidities such as hypertension and obesity. Chronically elevated left heart filling pressures often cause pulmonary venous congestion and increased pulmonary arterial pressure, resulting in pulmonary hypertension (PH-HFpEF) [1]. Interestingly, female patients often develop more pronounced pulmonary vascular remodeling but paradoxically experience better survival and preserved right ventricular (RV) function [2].
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Yogeswaran et al. (2026) conducted a review in Pulmonary hypertension in heart failure with preserved ejection fraction (PH-HFpEF). Female sex vs. Male sex was evaluated. Female patients with PH-HFpEF develop more pronounced pulmonary vascular remodeling but paradoxically experience better survival and preserved right ventricular function.
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