Heart failure with preserved ejection fraction in humans and mice: embracing clinical complexity in mouse models
Open accessAbstract
Heart failure (HF) with preserved ejection fraction (HFpEF) is a multifactorial disease accounting for a large and increasing proportion of all clinical HF presentations. As a clinical syndrome, HFpEF is characterized by typical signs and symptoms of HF, a distinct cardiac phenotype and raised natriuretic peptides. Non-cardiac comorbidities frequently co-exist and contribute to the pathophysiology of HFpEF. To date, no therapy has proven to improve outcomes in HFpEF, with drug development hampered, at least partly, by lack of consensus on appropriate standards for pre-clinical HFpEF models. Recently, two clinical algorithms (HFA-PEFF and H2FPEF scores) have been developed to improve and standardize the diagnosis of HFpEF. In this review, we evaluate the translational utility of HFpEF mouse models in the context of these HFpEF scores. We systematically recorded evidence of symptoms and signs of HF or clinical HFpEF features and included several cardiac and extra-cardiac parameters as well as age and sex for each HFpEF mouse model. We found that most of the pre-clinical HFpEF models do not meet the HFpEF clinical criteria, although some multifactorial models resemble human HFpEF to a reasonable extent. We therefore conclude that to optimize the translational value of mouse models to human HFpEF, a novel approach for the development of pre-clinical HFpEF models is needed, taking into account the complex HFpEF pathophysiology in humans.
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The murine model of HFpEF has several similarities with human HFpEF.
“We have shown previously that a murine model of HFpEF has several similarities with human HFpEF.27,28”
From The cardioprotective effects of semaglutide exceed those of dietary weight loss in mice with HFpEF (2023) · cites this paper as [27]
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Obesity-Related Heart Failure With a Preserved Ejection Fraction
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Animal models of heart failure with preserved ejection fraction
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A high-sugar and high-fat diet impairs cardiac systolic and diastolic function in mice
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The cardioprotective effects of semaglutide exceed those of dietary weight loss in mice with HFpEF
Withaar, C., Meems, L. M. G., Nollet, E. E., Schouten, E. M., Schroeder, M. A., Knudsen, L. B., Niss, K., Madsen, C. T., Hoegl, A., Mazzoni, G., et al. (2023) · JACC: Basic to Translational Science · doi:10.1016/j.jacbts.2023.05.012 · Cited by 74 · see citing works
Self-citation
- Authors
- Withaar, C., Lam, C. S. P., Schiattarella, G. G., de Boer, R. A., & Meems, L. M. G.
- Affiliations
- University Medical Center Groningen (NL)
- Max Delbrück Center (DE)
- Department of Cardiology, University of Groningen, University Medical Center Groningen , Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-08-20
- Volume
- 42
- Issue
- 43
- Pages
- 4420-4430
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC8599003
- OpenAlex
- W3194858310
- Cited by
- 150
- References
- 197
- Citations by year
- 2026: 25 · 2025: 28 · 2024: 34 · 2023: 26 · 2022: 34 · 2021: 2
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Heart Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Funders
- German Center for Cardiovascular Research
- Junior Research Group Excellence Grant
- National Medical Research Council of Singapore
- Netherlands Heart Foundation (2017-21, 2017-11, 2018-30, 2020B005)
- leDucq Foundation
- European Research Council (818715)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- heart failure with preserved ejection fraction, translational model, HFA-PEFF score, H2FPEF score, natriuretic peptides, non-cardiac comorbidities
- MeSH terms
- Algorithms, Animals, Heart Failure, Humans, Stroke Volume, Consensus, Natriuretic Peptides, Mice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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