Microvascular dysfunction in heart failure with preserved ejection fraction: pathophysiology, assessment, prevalence and prognostic implications

Joanna M.  Bilak; Uazman Alam; Christopher A. Miller; Gerry P. McCann; Jayanth R.  Arnold; Prathap  Kanagala

Microvascular dysfunction in heart failure with preserved ejection fraction: pathophysiology, assessment, prevalence and prognostic implications

Joanna M. Bilak, Uazman Alam, Christopher A. Miller, Gerry P. McCann, Jayanth R. Arnold, Prathap Kanagala

Division of Cardiovascular Sciences (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all HF cases and its prevalence continues to rise. Unlike heart failure with reduced ejection fraction (HFrEF) however, which is armed with a myriad of efficacious pharmacological and interventional therapies, HFpEF treatment options impacting mortality are limited. HFpEF is characterised by both clinical and pathophysiological heterogeneity, which may in part explain the diversity of treatment options available between the two HF phenotypes. Coronary microvascular dysfunction (MVD) has emerged as a key driver in the pathophysiology of HFpEF and may represent a potential therapeutic target. In this review, we describe the role of MVD with respect to pathophysiology, the differing invasive and non-invasive diagnostic strategies, prevalence and prognosis in relation to HFpEF.

Original language	English
Journal	Cardiac Failure Review
Publication status	Accepted/In press - 4 Apr 2022

Cite this

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title = "Microvascular dysfunction in heart failure with preserved ejection fraction: pathophysiology, assessment, prevalence and prognostic implications",

abstract = "Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all HF cases and its prevalence continues to rise. Unlike heart failure with reduced ejection fraction (HFrEF) however, which is armed with a myriad of efficacious pharmacological and interventional therapies, HFpEF treatment options impacting mortality are limited. HFpEF is characterised by both clinical and pathophysiological heterogeneity, which may in part explain the diversity of treatment options available between the two HF phenotypes. Coronary microvascular dysfunction (MVD) has emerged as a key driver in the pathophysiology of HFpEF and may represent a potential therapeutic target. In this review, we describe the role of MVD with respect to pathophysiology, the differing invasive and non-invasive diagnostic strategies, prevalence and prognosis in relation to HFpEF. ",

author = "Bilak, {Joanna M.} and Uazman Alam and Miller, {Christopher A.} and McCann, {Gerry P.} and Arnold, {Jayanth R.} and Prathap Kanagala",

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language = "English",

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AU - Bilak, Joanna M.

AU - Alam, Uazman

AU - Miller, Christopher A.

AU - McCann, Gerry P.

AU - Arnold, Jayanth R.

AU - Kanagala, Prathap

PY - 2022/4/4

Y1 - 2022/4/4

N2 - Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all HF cases and its prevalence continues to rise. Unlike heart failure with reduced ejection fraction (HFrEF) however, which is armed with a myriad of efficacious pharmacological and interventional therapies, HFpEF treatment options impacting mortality are limited. HFpEF is characterised by both clinical and pathophysiological heterogeneity, which may in part explain the diversity of treatment options available between the two HF phenotypes. Coronary microvascular dysfunction (MVD) has emerged as a key driver in the pathophysiology of HFpEF and may represent a potential therapeutic target. In this review, we describe the role of MVD with respect to pathophysiology, the differing invasive and non-invasive diagnostic strategies, prevalence and prognosis in relation to HFpEF.

AB - Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all HF cases and its prevalence continues to rise. Unlike heart failure with reduced ejection fraction (HFrEF) however, which is armed with a myriad of efficacious pharmacological and interventional therapies, HFpEF treatment options impacting mortality are limited. HFpEF is characterised by both clinical and pathophysiological heterogeneity, which may in part explain the diversity of treatment options available between the two HF phenotypes. Coronary microvascular dysfunction (MVD) has emerged as a key driver in the pathophysiology of HFpEF and may represent a potential therapeutic target. In this review, we describe the role of MVD with respect to pathophysiology, the differing invasive and non-invasive diagnostic strategies, prevalence and prognosis in relation to HFpEF.

M3 - Article

SN - 2057-7540

JO - Cardiac Failure Review

JF - Cardiac Failure Review

ER -

Microvascular dysfunction in heart failure with preserved ejection fraction: pathophysiology, assessment, prevalence and prognostic implications

Abstract

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