Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation.

Abstract:

:Renal dysfunction in heart failure with preserved ejection fraction (HFpEF) is common and is associated with increased mortality. Impaired renal function is also a risk factor for developing HFpEF. A new paradigm for HFpEF, proposing a sequence of events leading to myocardial remodelling and dysfunction in HFpEF, was recently introduced, involving inflammatory, microvascular, and cardiac components. The kidney might play a key role in this systemic process. Renal impairment causes metabolic and systemic derangements in circulating factors, causing an activated systemic inflammatory state and endothelial dysfunction, which may lead to cardiomyocyte stiffening, hypertrophy, and interstitial fibrosis via cross-talk between the endothelium and cardiomyocyte compartments. Here, we review the role of endothelial dysfunction and inflammation to explain the link between renal dysfunction and HFpEF, which allows for identification of new early risk markers, prognostic factors, and unique targets for intervention.

journal_name

Eur J Heart Fail

authors

Ter Maaten JM,Damman K,Verhaar MC,Paulus WJ,Duncker DJ,Cheng C,van Heerebeek L,Hillege HL,Lam CS,Navis G,Voors AA

doi

10.1002/ejhf.497

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

588-98

issue

6

eissn

1388-9842

issn

1879-0844

journal_volume

18

pub_type

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