期刊
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
卷 10, 期 3, 页码 261-274出版社
SPRINGER
DOI: 10.1007/s12265-017-9736-2
关键词
Heart failure with preserved ejection fraction; Arterial hemodynamics; Wave reflections; Afterload; Pulsatile load; Exercise intolerance; Comorbidities; Dementia; Renal disease
资金
- NIH [R01 HL 121510-01A1, R56HL-124073-01A1]
Multiple phase III trials over the last few decades have failed to demonstrate a clear benefit of various pharmacologic interventions in heart failure with a preserved left ventricular (LV) ejection fraction (HFpEF). Therefore, a better understanding of its pathophysiology is important. An accompanying review describes key technical and physiologic aspects regarding the deep phenotyping of arterial hemodynamics in HFpEF. This review deals with the potential of this approach to enhance our clinical, translational, and therapeutic approach to HFpEF. Specifically, the role of arterial hemodynamics is discussed in relation to (1) the pathophysiology of left ventricular diastolic dysfunction, remodeling, and fibrosis, (2) impaired oxygen delivery to peripheral skeletal muscle, which affects peripheral oxygen extraction, (3) the frequent presence of comorbidities, such as renal failure and dementia in this population, and (4) the potential to enhance precision medicine approaches. A therapeutic approach to target arterial hemodynamic abnormalities that are prevalent in this population (particularly, with inorganic nitrate/nitrite) is also discussed.
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