Biological Phenotypes of Heart Failure With Preserved Ejection Fraction

• Published in: Journal of the American College of Cardiology Vol. 70; no. 17; pp. 2186 - 2200
• Main Authors: Lewis, Gavin A., Schelbert, Erik B., Williams, Simon G., Cunnington, Colin, Ahmed, Fozia, McDonagh, Theresa A., Miller, Christopher A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 24.10.2017; Elsevier Limited
• Subjects: Blood Vessels - pathology; Cardiology; Cardiovascular; Clinical trials; Comorbidity; Diabetes; diastolic dysfunction; ejection fraction; Extracellular Matrix - pathology; Heart diseases; Heart failure; Heart Failure - complications; Heart Failure - pathology; Heart Failure - physiopathology; heart failure with preserved ejection fraction; Humans; Hypertension; Kidney Diseases - complications; Lung Diseases - complications; Morphology; Mortality; myocardial fibrosis; Obesity - complications; Peptides; Phenotype; Pulmonary Artery - pathology; Stroke Volume; Studies; Therapeutic applications; titin; heart failure; EF; ejection fraction; CMR; LV; HFpEF; ECM; myocardial fibrosis; titin; CVF; heart failure with preserved ejection fraction; LA; diastolic dysfunction; HF; LVH; left atrial; cardiovascular magnetic resonance; collagen volume fraction; left ventricular hypertrophy; left ventricular; extracellular matrix
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2017.09.006

Heart failure with preserved ejection fraction (HFpEF) involves multiple pathophysiological mechanisms, which result in the heterogeneous phenotypes that are evident clinically, and which have potentially confounded previous HFpEF trials. A greater understanding of the in vivo human processes involved, and in particular, which are the causes and which are the downstream effects, may allow the syndrome of HFpEF to be distilled into distinct diagnoses based on the underlying biology. From this, specific interventions can follow, targeting individuals identified on the basis of their biological phenotype. This review describes the biological phenotypes of HFpEF and therapeutic interventions aimed at targeting these phenotypes. [Display omitted]