Heart failure with preserved ejection fraction (HFpEF): what’s the problem?
HFpEF, is it more than just the sum of its parts?
Michael Marber, PhD
BHF Center of Research Excellence, Cardiovascular Division, The Rayne Institute, St Thomas’ Hospital, London, UK
- This issue of our journal focuses on the highly topical subject of heart failure with preserved left ventricular ejection fraction (HFpEF). It is clear from congresses and journals that HFpEF’s popularity is on the rise. This is hardly surprising given that its high prevalence, morbidity, and mortality combine with a lack of effective therapy. This combination provides the “perfect storm,” whipping up academic and commercial interest. Against such backdrop, the articles in this issue provide a balanced view of this field, which often attracts polarized opinion.
A good place to start is the “basic and clinical perspective” provided by Ajay Shah and Philip Chowienczyk. This article highlights the varied pathologies that drive HFpEF and makes the point that current guidelines recommend nothing other than the treatment of comorbidities because there is no clear mechanism of disease causation. Without a dominant mechanism driving disease, it’s difficult to create animal models that recapitulate the phenotype(s) seen in patients. The question is Why are patients with HFpEF so heterogeneous?
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