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Heart failure with preserved ejection fraction: a widespread unmet need for translational research and clinical management


Article Collection published

Guest edited by:
Prof Junjie Xiao

Heart failure with preserved ejection fraction (HFpEF) is a systemic complex clinical syndrome of heart failure generally associated with old age. Despite having normal or near normal ejection fraction (EF) and stroke volume, patients with HFpEF show high morbidity and mortality, as well as a frequent hospitalization rate. Given that current standard pharmacological treatment for heart failure with reduced ejection fraction (HFrEF) has not been proven to be effective for HFpEF, the prognosis and life quality of patients with HFpEF are unfortunately poor.

HFpEF is usually associated with factors such as old age, female gender, systolic hypertension, and diabetes. Given the heterogeneity of HFpEF, studies for the pathophysiology and molecular mechanism of HFpEF are urgently needed. However, animal models of HFpEF are for instance not widely employed at present. Meanwhile, substantial therapeutic targets for HFpEF needs to be explored in specific human patient subgroups, such as aging-, diabetic cardiomyopathy-, and metabolic and hypertensive stress-related HFpEF. Deciphering the complexity mechanism of HFpEF will promote our understanding of HFpEF and identify novel therapeutic targets and strategies for HFpEF. Translational, and clinical research are urgently needed to improve clinical diagnosis, treatment, and management of patients with HFpEF.

In this collection, BMC Medicine includes articles providing a translational and clinical overview of the most recent findings on HFpEF and future perspectives. Areas covered include risk stratification, comorbid atrial fibrillation, reviews on animal models, the role of adipose tissue and insights into how dapagliflozin attenuates diabetes-induced diastolic dysfunction and cardiac fibrosis. 

  1. Comorbidities are expected to impact the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). However, comorbidity profiles are usually reduced to a few comorbid disorders. Systems m...

    Authors: Jan D. Lanzer, Alberto Valdeolivas, Mark Pepin, Hauke Hund, Johannes Backs, Norbert Frey, Hans-Christoph Friederich, Jobst-Hendrik Schultz, Julio Saez-Rodriguez and Rebecca T. Levinson
    Citation: BMC Medicine 2023 21:267
  2. Epicardial adipose tissue (EAT) has been suggested to exert deleterious effects on myocardium and cardiovascular disease (CVD) consequence. We evaluated the associations of EAT thickness with adverse outcomes ...

    Authors: Manting Choy, Yuwen Huang, Yang Peng, Weihao Liang, Xin He, Chen Chen, Jiayong Li, Wengen Zhu, Fang-fei Wei, Yugang Dong, Chen Liu and Yuzhong Wu
    Citation: BMC Medicine 2023 21:117
  3. Diastolic dysfunction of the left ventricle (LVDD) is equally common in elderly women and men. LVDD is a condition that can remain latent for a long time but is also held responsible for elevated left ventricu...

    Authors: A. M. L. N. van Ommen, E. Dal Canto, Maarten J. Cramer, F. H. Rutten, N. C. Onland-Moret and H. M. den Ruijter
    Citation: BMC Medicine 2022 20:496
  4. Obesity is a well-defined risk factor for heart failure with preserved ejection fraction (HFpEF), but it is associated with a better prognosis in patients with diagnosed HFpEF. The paradoxically poor prognosis...

    Authors: Bin Dong, Yiling Yao, Ruicong Xue, Weihao Liang, Jiangui He, Fangfei Wei, Yugang Dong, Xin He and Chen Liu
    Citation: BMC Medicine 2022 20:423
  5. The prevalence of combined heart failure (HF) and atrial fibrillation (AF) is rising, and these patients suffer from high rates of mortality. This study aims to provide robust data on factors associated with d...

    Authors: Otilia Țica, Ovidiu Țica, Karina V. Bunting, Joseph deBono, Georgios V. Gkoutos, Mircea I. Popescu and Dipak Kotecha
    Citation: BMC Medicine 2022 20:331
  6. Recent studies have reported improved diastolic function in patients administered sodium-glucose cotransporter 2 inhibitors (SGLT2i). We aimed to investigate the effect of dapagliflozin on left ventricular (LV...

    Authors: Seul-Gee Lee, Darae Kim, Jung-Jae Lee, Hyun-Ju Lee, Ro-kyung Moon, Yong-Joon Lee, Seung-Jun Lee, Oh-Hyun Lee, Choongki Kim, Jaewon Oh, Chan Joo Lee, Yong-ho Lee, Seil Park, Ok-Hee Jeon, Donghoon Choi, Geu-Ru Hong…
    Citation: BMC Medicine 2022 20:309
  7. HRV has mostly shown associations with systolic dysfunction and more recently, with diastolic dysfunction in Heart failure (HF) patients. But the role of sympathetic nervous system in changes of left ventricul...

    Authors: Banafsheh Arshi, Sven Geurts, Martijn J. Tilly, Marten van den Berg, Jan A. Kors, Dimitris Rizopoulos, M. Arfan Ikram and Maryam Kavousi
    Citation: BMC Medicine 2022 20:91
  8. Heart failure with preserved ejection fraction (HFpEF) is the dominant form of heart failure (HF). We here aimed to investigate the characteristics and prognosis of HFpEF in patients with hypertrophic cardiomy...

    Authors: Jie Liu, Dong Wang, Jieyun Ruan, Guixin Wu, Lianjun Xu, Wen Jiang, Jizheng Wang, Xiaolu Sun, Lianming Kang and Lei Song
    Citation: BMC Medicine 2022 20:21