Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction: Pathophysiology, Assessment, Prevalence and Prognosis

Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all new heart failure cases in the community. HFpEF is closely associated with chronic lifestyle-related diseases, such as obesity and type 2 diabetes, and clinical outcomes are worse in those with th...

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Bibliographic Details
Published in:Cardiac failure review 2022-01, Vol.8, p.e24
Main Authors: Bilak, Joanna M, Alam, Uazman, Miller, Christopher A, McCann, Gerry P, Arnold, Jayanth R, Kanagala, Prathap
Format: Article
Language:English
Subjects:
Comorbidity
Heart failure
Patients with HFpEF
Prognosis
Type 2 diabetes
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Summary:Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all new heart failure cases in the community. HFpEF is closely associated with chronic lifestyle-related diseases, such as obesity and type 2 diabetes, and clinical outcomes are worse in those with than without comorbidities. HFpEF is pathophysiologically distinct from heart failure with reduced ejection fraction, which may explain, in part, the disparity of treatment options available between the two heart failure phenotypes. The mechanisms underlying HFpEF are complex, with coronary microvascular dysfunction (MVD) being proposed as a potential key driver in its pathophysiology. In this review, the authors highlight the evidence implicating MVD in HFpEF pathophysiology, the diagnostic approaches for identifying MVD (both invasive and non-invasive) and the prevalence and prognostic significance of MVD.
ISSN:2057-7540
2057-7559
DOI:10.15420/cfr.2022.12