Cited by 150Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementCardiac Fibrosis and Remodeling

Heart failure with preserved ejection fraction in humans and mice: embracing clinical complexity in mouse models

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Withaar, Coenraad, Lam, Carolyn S P, Schiattarella, Gabriele G, de Boer, Rudolf A, Meems, Laura M G·2021·European Heart Journal

Abstract

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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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
Published
2021-08-20
Volume
42
Issue
43
Pages
4420-4430
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
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
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

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