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Main Authors: Payel Sen, Lili Wang, Laura d'Ambrosio, Susanne Bierschenk, Jules Hamers, Irem Ornek, Theresa Sittig, Hengliang Zhang, Junqing Zhang, Daphne Merkus
Format: Artículo Open Access
Published: Wiley 2025
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Online Access:https://physoc.onlinelibrary.wiley.com/doi/10.14814/phy2.70521
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author Payel Sen
Lili Wang
Laura d'Ambrosio
Susanne Bierschenk
Jules Hamers
Irem Ornek
Theresa Sittig
Hengliang Zhang
Junqing Zhang
Daphne Merkus
author_facet Payel Sen
Lili Wang
Laura d'Ambrosio
Susanne Bierschenk
Jules Hamers
Irem Ornek
Theresa Sittig
Hengliang Zhang
Junqing Zhang
Daphne Merkus
Payel Sen
Lili Wang
Laura d'Ambrosio
Susanne Bierschenk
Jules Hamers
Irem Ornek
Theresa Sittig
Hengliang Zhang
Junqing Zhang
Daphne Merkus
collection Wiley Open Access
contents Coronary microvascular disease in heart failure with preserved ejection fraction Payel Sen Lili Wang Laura d'Ambrosio Susanne Bierschenk Jules Hamers Irem Ornek Theresa Sittig Hengliang Zhang Junqing Zhang Daphne Merkus Physiological Reports AbstractThe prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing because of an aging population and an unhealthy, sedentary lifestyle, predisposing to diabetes, obesity, dyslipidemia, hypertension, and chronic kidney disease. A substantial proportion of patients with HFpEF exhibits coronary microvascular disease (CMD), and the combination of CMD with left ventricular diastolic dysfunction is associated with worse outcomes. Distinct patient clusters within HFpEF populations are based on clinical and biomarker profiles, each with unique prognoses and comorbidity patterns. Most patients with HFpEF present with multiple comorbidities, adding to the disease's complexity. Since risk factors directly affect the coronary microvasculature—and considering the bidirectional paracrine signaling between cardiomyocytes and the microvasculature—there is significant pathophysiological overlap between HFpEF and CMD. Therefore, in this review, we aim to summarize epidemiological evidence for the overlap in patients with CMD and HFpEF, identify shared biomarkers pathophysiological pathways underlying the co‐occurrence of CMD and HFpEF, and discuss how cardiometabolic interventions may simultaneously address both CMD and HFpEF. Established and emerging treatments for HFpEF and CMD target these shared mechanisms. A deeper understanding of these interrelated pathways may pave the way for novel therapeutic strategies to alleviate the burden of HFpEF and refine patient management. 10.14814/phy2.70521 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.14814/phy2.70521
format Artículo Open Access
id wiley_oa_10_14814_phy2_70521
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2025
publisher Wiley
record_format wiley_oa
spellingShingle Coronary microvascular disease in heart failure with preserved ejection fraction
Payel Sen
Lili Wang
Laura d'Ambrosio
Susanne Bierschenk
Jules Hamers
Irem Ornek
Theresa Sittig
Hengliang Zhang
Junqing Zhang
Daphne Merkus
Physiological Reports
Coronary microvascular disease in heart failure with preserved ejection fraction Payel Sen Lili Wang Laura d'Ambrosio Susanne Bierschenk Jules Hamers Irem Ornek Theresa Sittig Hengliang Zhang Junqing Zhang Daphne Merkus Physiological Reports AbstractThe prevalence of heart failure with preserved ejection fraction (HFpEF) is increasing because of an aging population and an unhealthy, sedentary lifestyle, predisposing to diabetes, obesity, dyslipidemia, hypertension, and chronic kidney disease. A substantial proportion of patients with HFpEF exhibits coronary microvascular disease (CMD), and the combination of CMD with left ventricular diastolic dysfunction is associated with worse outcomes. Distinct patient clusters within HFpEF populations are based on clinical and biomarker profiles, each with unique prognoses and comorbidity patterns. Most patients with HFpEF present with multiple comorbidities, adding to the disease's complexity. Since risk factors directly affect the coronary microvasculature—and considering the bidirectional paracrine signaling between cardiomyocytes and the microvasculature—there is significant pathophysiological overlap between HFpEF and CMD. Therefore, in this review, we aim to summarize epidemiological evidence for the overlap in patients with CMD and HFpEF, identify shared biomarkers pathophysiological pathways underlying the co‐occurrence of CMD and HFpEF, and discuss how cardiometabolic interventions may simultaneously address both CMD and HFpEF. Established and emerging treatments for HFpEF and CMD target these shared mechanisms. A deeper understanding of these interrelated pathways may pave the way for novel therapeutic strategies to alleviate the burden of HFpEF and refine patient management. 10.14814/phy2.70521 http://creativecommons.org/licenses/by/4.0/
title Coronary microvascular disease in heart failure with preserved ejection fraction
topic Physiological Reports
url https://physoc.onlinelibrary.wiley.com/doi/10.14814/phy2.70521