Cited by 508Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsCardiovascular and exercise physiology

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Heart Failure With Preserved Ejection Fraction: Mechanisms, Clinical Features, and Therapies

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Sharma, Kavita, Kass, David A.·2014·Circulation Research

DOI 10.1161/circresaha.115.302922PMC PMC4146618

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Abstract

The clinical syndrome comprising heart failure (HF) symptoms but with a left ventricular ejection fraction (EF) that is not diminished, eg, HF with preserved EF, is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common comorbidities. Importantly, its morbidity and mortality are on par with HF with reduced EF, and as the list of failed treatments continues to grow, HF with preserved EF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and redirect our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HF with preserved EF and give perspectives on its evolving demographics and epidemiology, the role of multiorgan deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions.

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10.1016/j.jacc.2006.08.050 · DOI
10.1161/CIRCULATIONAHA.106.659763 · DOI
10.1161/circulationaha.107.716886 · DOI
10.1016/S0140-6736(03)14285-7 · DOI · Paper page
10.1016/j · DOI

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Authors: Sharma, K., & Kass, D. A.
Affiliations: Johns Hopkins University (US)
ORCID: Sharma, Kavita
Kass, David A.
Venue: Circulation Research
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-06-20
Volume: 115
Issue: 1
Pages: 79-96
ISSN: 0009-7330 (ISSN-L)
1524-4571
DOI: 10.1161/circresaha.115.302922
PMC: PMC4146618
OpenAlex: W2527933700
Cited by: 508
References: 178
Citations by year: 2026: 21 · 2025: 21 · 2024: 42 · 2023: 31 · 2022: 36 · 2021: 48 · 2020: 53 · 2019: 44 · 2018: 53 · 2017: 63 · 2016: 42 · 2015: 43 · 2014: 10
FWCI: 8.39
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation Research (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL114910, P01HL077180, R01HL119012, HL-077180, HL-119012, HL114910, T32HL007227)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
Keywords: heart failure with preserved ejection fraction, left ventricular ejection fraction, heart failure pathophysiology, multiple organ failure, heart failure epidemiology, translational research, clinical trials, unmet medical needs
MeSH terms: Diastole, Energy Metabolism, Exercise Therapy, Heart Failure, Humans, Hypertension, Pulmonary, Inflammation, Stroke Volume, Systole, Ventricular Function, Left, Cyclic GMP-Dependent Protein Kinases, Muscle, Skeletal

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Heart Failure With Preserved Ejection Fraction: Mechanisms, Clinical Features, and Therapies

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