Reconsidering the pathophysiology of heart failure with preserved ejection fraction and diastolic dysfunction

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  • Kihara Yasuki
    Director, Kobe City Medical Center General Hospital Professor Emeritus （Cardiovascular Medicine）, Hiroshima University

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  • 左室駆出率の保持された心不全（Heart Failure with Preserved Ejection Fraction； HFpEF）の本質と心不全パンデミック

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Heart failure with preserved ejection fraction (HFpEF), a novel concept of heart failure with normal contractile performance, plays a substantial role in the elderly population in Japan. The underlying pathophysiology of HFpEF may be a stiffening ventricle and its subsequent diastolic noncompliance. However, recent investigations suggest more complex interactions between the ventricle and peripheral organs including sclerotic arterioles, sarcopenic skeletal muscles, and imbalanced autonomic nervous systems. The author summarizes the limitations of the diastolic dysfunction theory and what would be expected from the new theory of organ interactions.

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