Pathophysiology and Treatment Strategies of Comorbidities in Heart Failure with Preserved Ejection Fraction
The pathophysiological mechanisms of heart failure with preserved ejection fraction(HFpEF)are not yet fully understood.It is currently believed to be associated with cellular autophagy mediated by the renin-angiotensin-aldosterone system,advanced glycation end products-receptor for advanced glycation end products,coronary microvascular inflammation,oxidative stress,inflammatory response,and cardiac energy metabolism disorder.Hypertension,diabetes,coronary artery disease,and atrial fibrillation can lead to increased left ventricular myocardial stiffness and impaired diastolic filling through various pathways,promoting HFpEF.Current studies have shown that the drugs which can improve the prognosis of HFpEF are mainly sodium-glucose cotransporter 2 inhibitor,and the treatment of heart failure with reduced ejection fraction is not applicable to HFpEF,so it is important to control the development of HFpEF by early prevention and treatment of its comorbidities.This paper reviews the pathological mechanisms and treatment of the common comorbidities of HFpEF to help the clinical management of HFpEF.
Heart failure with preserved ejection fractionHypertensionDiabetes mellitusPathological mechanismTreatment guidelines