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February 2, 2026Reviews in Cardiovascular Medicine0 citationsOpen Access

Pathogenesis and Therapeutic Advances in Heart Failure with Preserved Ejection Fraction

XFXin FanJMJie MaXZXu Zhao

Key Result

RAS inhibitors significantly reduce the risk of primary composite outcome in patients with HFpEF.

Key Points

  • The aim is to summarize progress in understanding the mechanisms of heart failure with preserved ejection fraction and novel treatments.
  • Review of recent studies on HFpEF mechanisms and therapeutic approaches.
  • Analysis of molecular factors contributing to HFpEF pathogenesis.
  • Evaluation of therapeutic strategies targeting inflammation and metabolic dysregulation.
  • Heart failure with preserved ejection fraction has become the most common type of heart failure.
  • Increased focus on molecular mechanisms like inflammation and oxidative stress in HFpEF.
  • Emerging therapies targeting specific pathways offer potential new management options.

Study Design

Type

Meta-Analysis (n=30,882)

Blinding

null

Randomization

null

Structured PICO

P
Population
Patients with heart failure with preserved ejection fraction (HFpEF)

This review provides a comprehensive overview of the molecular mechanisms driving HFpEF, particularly inflammation and oxidative stress, and outlines current and emerging targeted therapies.

Main Result

Effect estimate: OR 0.87 (95% CI 0.82-0.93)

p-value: p=null

Limitations

  • Limited studies assessed long-term benefits of RAS inhibitors in HFpEF.
  • Variation in patient characteristics could affect outcomes.

Abstract

Heart failure with preserved ejection fraction (HFpEF) has progressively emerged as the predominant form of heart failure. Thus, studies on the underlying mechanisms of HFpEF have shifted from pathophysiological to molecular factors. Meanwhile, previous studies have primarily focused on inflammation, oxidative stress, metabolic dysregulation, and impaired cardiac compliance (manifesting as ventricular hypertrophy and interstitial fibrosis). In addition to conventional guideline-directed medical therapies, novel therapeutic strategies targeting these aforementioned pathogenic pathways have been investigated. This review aimed to summarize recent progress in HFpEF pathogenesis and emerging treatment approaches, offering insights for developing novel diagnostic and management strategies.

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Cite This Study

Fan et al. (2026) conducted a meta-analysis in Heart Failure with Preserved Ejection Fraction (HFpEF) (n=30,882). RAS inhibitors vs. placebo was evaluated on Composite outcome of cardiovascular death and hospitalization for heart failure (OR 0.87, 95% CI 0.82-0.93, p=null). RAS inhibitors significantly reduce the risk of primary composite outcome in patients with HFpEF.

synapsesocial.com/papers/6980fc37c1c9540dea80e091https://doi.org/10.31083/rcm45613
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