TY - JOUR
T1 - Immunomodulation in Heart Failure with Preserved Ejection Fraction
T2 - Current State and Future Perspectives
AU - Kessler, Elise L.
AU - Oerlemans, Martinus I.F.J.
AU - van den Hoogen, Patricia
AU - Yap, Carmen
AU - Sluijter, Joost P.G.
AU - de Jager, Saskia C.A.
N1 - Funding Information:
This work was funded by the Netherlands Heart Institute (Fellowship for ELK), the Netherlands Cardiovascular Research Initiative: An initiative with support of the Dutch Heart Foundation [CVON2014-11 RECONNECT], and the Dutch Heart Foundation (2013T084, Queen of Hearts program) to JPGS and SCAdJ. This work was also supported by the Project EVICARE (725229) of the European Research Council (ERC) to JPGS.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - The heart failure (HF) epidemic is growing and approximately half of the HF patients have heart failure with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous syndrome, characterized by a preserved left ventricular ejection fraction (LVEF ≥ 50%) with diastolic dysfunction, and is associated with high morbidity and mortality. Underlying comorbidities of HFpEF, i.e., hypertension, type 2 diabetes mellitus, obesity, and renal failure, lead to a systemic pro-inflammatory state, thereby affecting normal cardiac function. Increased inflammatory biomarkers predict incident HFpEF and are higher in patients with HFpEF as compared with heart failure with reduced ejection fraction (HFrEF). Randomized trials in HFpEF patients using traditional HF medication failed to demonstrate a clear benefit on hard endpoints (mortality and/or HF hospitalization). Therefore, therapies targeting underlying comorbidities and systemic inflammation in early HFpEF may provide better opportunities. Here, we provide an overview of the current state and future perspectives of immunomodulatory therapies for HFpEF.
AB - The heart failure (HF) epidemic is growing and approximately half of the HF patients have heart failure with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous syndrome, characterized by a preserved left ventricular ejection fraction (LVEF ≥ 50%) with diastolic dysfunction, and is associated with high morbidity and mortality. Underlying comorbidities of HFpEF, i.e., hypertension, type 2 diabetes mellitus, obesity, and renal failure, lead to a systemic pro-inflammatory state, thereby affecting normal cardiac function. Increased inflammatory biomarkers predict incident HFpEF and are higher in patients with HFpEF as compared with heart failure with reduced ejection fraction (HFrEF). Randomized trials in HFpEF patients using traditional HF medication failed to demonstrate a clear benefit on hard endpoints (mortality and/or HF hospitalization). Therefore, therapies targeting underlying comorbidities and systemic inflammation in early HFpEF may provide better opportunities. Here, we provide an overview of the current state and future perspectives of immunomodulatory therapies for HFpEF.
KW - Clinical trials
KW - HFpEF
KW - Immunomodulation
KW - Inflammation
KW - LVDD
KW - Preclinical models
UR - http://www.scopus.com/inward/record.url?scp=85085302808&partnerID=8YFLogxK
U2 - 10.1007/s12265-020-10026-3
DO - 10.1007/s12265-020-10026-3
M3 - Review article
C2 - 32444946
AN - SCOPUS:85085302808
SN - 1937-5387
VL - 14
SP - 63
EP - 74
JO - Journal of Cardiovascular Translational Research
JF - Journal of Cardiovascular Translational Research
IS - 1
ER -