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Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome responsible for high mortality and morbidity rates. It has an ever growing social and economic impact and a deeper knowledge of molecular and pathophysiological basis is essential for the ideal management of HFpEF...

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Autores principales: Severino, Paolo, D’Amato, Andrea, Prosperi, Silvia, Fanisio, Francesca, Birtolo, Lucia Ilaria, Costi, Bettina, Netti, Lucrezia, Chimenti, Cristina, Lavalle, Carlo, Maestrini, Viviana, Mancone, Massimo, Fedele, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304780/
https://www.ncbi.nlm.nih.gov/pubmed/34299270
http://dx.doi.org/10.3390/ijms22147650
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author Severino, Paolo
D’Amato, Andrea
Prosperi, Silvia
Fanisio, Francesca
Birtolo, Lucia Ilaria
Costi, Bettina
Netti, Lucrezia
Chimenti, Cristina
Lavalle, Carlo
Maestrini, Viviana
Mancone, Massimo
Fedele, Francesco
author_facet Severino, Paolo
D’Amato, Andrea
Prosperi, Silvia
Fanisio, Francesca
Birtolo, Lucia Ilaria
Costi, Bettina
Netti, Lucrezia
Chimenti, Cristina
Lavalle, Carlo
Maestrini, Viviana
Mancone, Massimo
Fedele, Francesco
author_sort Severino, Paolo
collection PubMed
description Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome responsible for high mortality and morbidity rates. It has an ever growing social and economic impact and a deeper knowledge of molecular and pathophysiological basis is essential for the ideal management of HFpEF patients. The association between HFpEF and traditional cardiovascular risk factors is known. However, myocardial alterations, as well as pathophysiological mechanisms involved are not completely defined. Under the definition of HFpEF there is a wide spectrum of different myocardial structural alterations. Myocardial hypertrophy and fibrosis, coronary microvascular dysfunction, oxidative stress and inflammation are only some of the main pathological detectable processes. Furthermore, there is a lack of effective pharmacological targets to improve HFpEF patients’ outcomes and risk factors control is the primary and unique approach to treat those patients. Myocardial tissue characterization, through invasive and non-invasive techniques, such as endomyocardial biopsy and cardiac magnetic resonance respectively, may represent the starting point to understand the genetic, molecular and pathophysiological mechanisms underlying this complex syndrome. The correlation between histopathological findings and imaging aspects may be the future challenge for the earlier and large-scale HFpEF diagnosis, in order to plan a specific and effective treatment able to modify the disease’s natural course.
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spelling pubmed-83047802021-07-25 Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets Severino, Paolo D’Amato, Andrea Prosperi, Silvia Fanisio, Francesca Birtolo, Lucia Ilaria Costi, Bettina Netti, Lucrezia Chimenti, Cristina Lavalle, Carlo Maestrini, Viviana Mancone, Massimo Fedele, Francesco Int J Mol Sci Review Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome responsible for high mortality and morbidity rates. It has an ever growing social and economic impact and a deeper knowledge of molecular and pathophysiological basis is essential for the ideal management of HFpEF patients. The association between HFpEF and traditional cardiovascular risk factors is known. However, myocardial alterations, as well as pathophysiological mechanisms involved are not completely defined. Under the definition of HFpEF there is a wide spectrum of different myocardial structural alterations. Myocardial hypertrophy and fibrosis, coronary microvascular dysfunction, oxidative stress and inflammation are only some of the main pathological detectable processes. Furthermore, there is a lack of effective pharmacological targets to improve HFpEF patients’ outcomes and risk factors control is the primary and unique approach to treat those patients. Myocardial tissue characterization, through invasive and non-invasive techniques, such as endomyocardial biopsy and cardiac magnetic resonance respectively, may represent the starting point to understand the genetic, molecular and pathophysiological mechanisms underlying this complex syndrome. The correlation between histopathological findings and imaging aspects may be the future challenge for the earlier and large-scale HFpEF diagnosis, in order to plan a specific and effective treatment able to modify the disease’s natural course. MDPI 2021-07-17 /pmc/articles/PMC8304780/ /pubmed/34299270 http://dx.doi.org/10.3390/ijms22147650 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Severino, Paolo
D’Amato, Andrea
Prosperi, Silvia
Fanisio, Francesca
Birtolo, Lucia Ilaria
Costi, Bettina
Netti, Lucrezia
Chimenti, Cristina
Lavalle, Carlo
Maestrini, Viviana
Mancone, Massimo
Fedele, Francesco
Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title_full Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title_fullStr Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title_full_unstemmed Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title_short Myocardial Tissue Characterization in Heart Failure with Preserved Ejection Fraction: From Histopathology and Cardiac Magnetic Resonance Findings to Therapeutic Targets
title_sort myocardial tissue characterization in heart failure with preserved ejection fraction: from histopathology and cardiac magnetic resonance findings to therapeutic targets
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304780/
https://www.ncbi.nlm.nih.gov/pubmed/34299270
http://dx.doi.org/10.3390/ijms22147650
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