Microvascular and lymphatic dysfunction in HFpEF and its associated comorbidities

Heart failure with preserved ejection fraction (HFpEF) is a complex heterogeneous disease for which our pathophysiological understanding is still limited and specifc prevention and treatment strategies are lacking. HFpEF is characterised by diastolic dysfunction and cardiac remodelling (fbrosis, inf...

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Detalles Bibliográficos
Autores: Cuijpers, I. (Ilona)|||/items/18b5a8f5-1c8f-4a8b-b2af-bbfe65f82938, Simmonds, S. (Steven J.)|||/items/394bcf7a-7227-467e-b3ed-fe6b7112a375, Bilsen, M. (Marc) van|||/items/3bdfe950-4b5e-472c-b676-f0b2a664fe2d, Czarnowska, E. (Elzbieta)|||/items/f47eb91a-4975-4fa7-88bd-f5167a62829a, González-Miqueo, A. (Aránzazu)|||/items/74f4670c-e6aa-43b6-82f9-f6ed120089cb, Heymans, S. (Stephane)|||/items/640c68d4-b80a-4923-bf08-10f868604375, Kuhn, A.R. (Annika R.)|||/items/941f8d5b-7ded-4344-8aac-4d49a5971549, Mulder, P. (Paul)|||/items/b77a19af-d842-4f56-99ed-10911ed169e9, Ratajska, A. (Anna)|||/items/f7a08a78-7058-436d-8561-f59d07638c55, Jones, E.A.V. (Elizabeth A. V.)|||/items/746017fa-3c62-4539-aab6-7411732a08a9, Brakenhielm, E. (Ebba)|||/items/5f91c870-72f7-4d31-bfc8-336cb9a3f191
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/66473
Acceso en línea:https://hdl.handle.net/10171/66473
Access Level:acceso abierto
Palabra clave:Heart failure with preserved ejection fraction
Coronary microvascular dysfunction
Cardiac lymphatic dysfunction
Infammation
Myocardial fbrosis
Cardiac metabolism
Descripción
Sumario:Heart failure with preserved ejection fraction (HFpEF) is a complex heterogeneous disease for which our pathophysiological understanding is still limited and specifc prevention and treatment strategies are lacking. HFpEF is characterised by diastolic dysfunction and cardiac remodelling (fbrosis, infammation, and hypertrophy). Recently, microvascular dysfunction and chronic low-grade infammation have been proposed to participate in HFpEF development. Furthermore, several recent studies demonstrated the occurrence of generalized lymphatic dysfunction in experimental models of risk factors for HFpEF, including obesity, hypercholesterolaemia, type 2 diabetes mellitus (T2DM), hypertension, and aging. Here, we review the evidence for a combined role of coronary (micro)vascular dysfunction and lymphatic vessel alterations in mediating key pathological steps in HFpEF, including reduced cardiac perfusion, chronic low-grade infammation, and myocardial oedema, and their impact on cardiac metabolic alterations (oxygen and nutrient supply/demand imbalance), fbrosis, and cardiomyocyte stifness. We focus primarily on HFpEF caused by metabolic risk factors, such as obesity, T2DM, hypertension, and aging.

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