Cargando…

Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease

Heart failure with preserved ejection fraction (HFpEF) is a complex, heterogeneous disease characterized by autonomic imbalance, cardiac remodeling, and diastolic dysfunction. One feature that has recently been linked to the pathology is the presence of macrovascular and microvascular dysfunction. I...

Descripción completa

Detalles Bibliográficos
Autores principales: Saavedra-Alvarez, Andrea, Pereyra, Katherine V., Toledo, Camilo, Iturriaga, Rodrigo, Del Rio, Rodrigo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810809/
https://www.ncbi.nlm.nih.gov/pubmed/36620616
http://dx.doi.org/10.3389/fcvm.2022.1070935
_version_ 1784863386580811776
author Saavedra-Alvarez, Andrea
Pereyra, Katherine V.
Toledo, Camilo
Iturriaga, Rodrigo
Del Rio, Rodrigo
author_facet Saavedra-Alvarez, Andrea
Pereyra, Katherine V.
Toledo, Camilo
Iturriaga, Rodrigo
Del Rio, Rodrigo
author_sort Saavedra-Alvarez, Andrea
collection PubMed
description Heart failure with preserved ejection fraction (HFpEF) is a complex, heterogeneous disease characterized by autonomic imbalance, cardiac remodeling, and diastolic dysfunction. One feature that has recently been linked to the pathology is the presence of macrovascular and microvascular dysfunction. Indeed, vascular dysfunction directly affects the functionality of cardiomyocytes, leading to decreased dilatation capacity and increased cell rigidity, which are the outcomes of the progressive decline in myocardial function. The presence of an inflammatory condition in HFpEF produced by an increase in proinflammatory molecules and activation of immune cells (i.e., chronic low-grade inflammation) has been proposed to play a pivotal role in vascular remodeling and endothelial cell death, which may ultimately lead to increased arterial elastance, decreased myocardium perfusion, and decreased oxygen supply to the tissue. Despite this, the precise mechanism linking low-grade inflammation to vascular alterations in the setting of HFpEF is not completely known. However, the enhanced sympathetic vasomotor tone in HFpEF, which may result from inflammatory activation of the sympathetic nervous system, could contribute to orchestrate vascular dysfunction in the setting of HFpEF due to the exquisite sympathetic innervation of both the macro and microvasculature. Accordingly, the present brief review aims to discuss the main mechanisms that may be involved in the macro- and microvascular function impairment in HFpEF and the potential role of the sympathetic nervous system in vascular dysfunction.
format Online
Article
Text
id pubmed-9810809
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98108092023-01-05 Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease Saavedra-Alvarez, Andrea Pereyra, Katherine V. Toledo, Camilo Iturriaga, Rodrigo Del Rio, Rodrigo Front Cardiovasc Med Cardiovascular Medicine Heart failure with preserved ejection fraction (HFpEF) is a complex, heterogeneous disease characterized by autonomic imbalance, cardiac remodeling, and diastolic dysfunction. One feature that has recently been linked to the pathology is the presence of macrovascular and microvascular dysfunction. Indeed, vascular dysfunction directly affects the functionality of cardiomyocytes, leading to decreased dilatation capacity and increased cell rigidity, which are the outcomes of the progressive decline in myocardial function. The presence of an inflammatory condition in HFpEF produced by an increase in proinflammatory molecules and activation of immune cells (i.e., chronic low-grade inflammation) has been proposed to play a pivotal role in vascular remodeling and endothelial cell death, which may ultimately lead to increased arterial elastance, decreased myocardium perfusion, and decreased oxygen supply to the tissue. Despite this, the precise mechanism linking low-grade inflammation to vascular alterations in the setting of HFpEF is not completely known. However, the enhanced sympathetic vasomotor tone in HFpEF, which may result from inflammatory activation of the sympathetic nervous system, could contribute to orchestrate vascular dysfunction in the setting of HFpEF due to the exquisite sympathetic innervation of both the macro and microvasculature. Accordingly, the present brief review aims to discuss the main mechanisms that may be involved in the macro- and microvascular function impairment in HFpEF and the potential role of the sympathetic nervous system in vascular dysfunction. Frontiers Media S.A. 2022-12-21 /pmc/articles/PMC9810809/ /pubmed/36620616 http://dx.doi.org/10.3389/fcvm.2022.1070935 Text en Copyright © 2022 Saavedra-Alvarez, Pereyra, Toledo, Iturriaga and Del Rio. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Saavedra-Alvarez, Andrea
Pereyra, Katherine V.
Toledo, Camilo
Iturriaga, Rodrigo
Del Rio, Rodrigo
Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title_full Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title_fullStr Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title_full_unstemmed Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title_short Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease
title_sort vascular dysfunction in hfpef: potential role in the development, maintenance, and progression of the disease
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810809/
https://www.ncbi.nlm.nih.gov/pubmed/36620616
http://dx.doi.org/10.3389/fcvm.2022.1070935
work_keys_str_mv AT saavedraalvarezandrea vasculardysfunctioninhfpefpotentialroleinthedevelopmentmaintenanceandprogressionofthedisease
AT pereyrakatherinev vasculardysfunctioninhfpefpotentialroleinthedevelopmentmaintenanceandprogressionofthedisease
AT toledocamilo vasculardysfunctioninhfpefpotentialroleinthedevelopmentmaintenanceandprogressionofthedisease
AT iturriagarodrigo vasculardysfunctioninhfpefpotentialroleinthedevelopmentmaintenanceandprogressionofthedisease
AT delriorodrigo vasculardysfunctioninhfpefpotentialroleinthedevelopmentmaintenanceandprogressionofthedisease