Korean J Intern Med.  2016 Jan;31(1):1-14. 10.3904/kjim.2016.31.1.1.

Breakthrough in heart failure with preserved ejection fraction: are we there yet?

Affiliations
  • 1Department of Cardiology, National University Heart Center, Singapore.
  • 2Department of Cardiology, National Heart Center Singapore, Singapore. carolyn_lam@nuhs.edu.sg
  • 3Cardiovascular and Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore.

Abstract

Heart failure with preserved ejection fraction (HFPEF) is a global health problem of considerable socioeconomic burden. It is projected to worsen with the aging population worldwide. The lack of effective therapies underscores our incomplete understanding of this complex heterogeneous syndrome. A novel paradigm has recently emerged, in which central roles are ascribed to systemic inflammation and generalized endothelial dysfunction in the pathophysiology of HFPEF. In this review, we discuss the role of the endothelium in cardiovascular homeostasis and how deranged endothelial-related signaling pathways contribute to the development of HFPEF. We also review the novel therapies in various stages of research and development that target different components of this signaling pathway.

Keyword

Heart failure with preserved ejection fraction; Systemic inflammation; Endothelial dysfunction; Novel therapies

MeSH Terms

Animals
Endothelium, Vascular/*physiopathology
Heart Failure/diagnosis/metabolism/*physiopathology/therapy
Humans
Inflammation/diagnosis/metabolism/*physiopathology/therapy
Inflammation Mediators/metabolism
Prognosis
Risk Factors
Signal Transduction
*Stroke Volume
*Ventricular Function, Left
Inflammation Mediators
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