Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction: Pathophysiology, Assessment, Prevalence and Prognosis-Reference-Cited by-同舟云学术

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

Published:2022-07-01 Issue: Volume:8 Page:
ISSN:2057-7559
Container-title:Cardiac Failure Review
language:en
Short-container-title:Card Fail Rev

Author:

Bilak Joanna M¹^ORCID,Alam Uazman²^ORCID,Miller Christopher A³^ORCID,McCann Gerry P¹^ORCID,Arnold Jayanth R¹^ORCID,Kanagala Prathap⁴^ORCID

Affiliation:

1. Department of Cardiovascular Sciences, University of Leicester and the Leicester NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, UK

2. Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Division of Diabetes, Endocrinology and Gastroenterology, Institute of Human Development, University of Manchester, Manchester, UK; Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK

3. Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

4. Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Liverpool Centre for Cardiovascular Sciences, Faculty of Health and Life Sciences, Liverpool, UK

Abstract

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.

Funder

British Society for Heart Failure

NIHR Leicester Biomedical Research Centre

Publisher

Radcliffe Media Media Ltd

Subject

Cardiology and Cardiovascular Medicine

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