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. Author manuscript; available in PMC: 2024 Dec 1.
Published in final edited form as: Ann N Y Acad Sci. 2023 Oct 30;1530(1):64–73. doi: 10.1111/nyas.15078

FIGURE 2.

FIGURE 2

(Left) Pictorial representation of HFpEF physiology. Left ventricular diastolic dysfunction causes high left ventricular (LV) filling pressures, left atrial (LA) hypertension, pulmonary hypertension, poor right ventricular (RV) filling through RV–LV cross-talk, poor RV systolic function because of increased afterload, leading to increased right atrial (RA) pressures and naturetic protein release (ANP and BNP). (Right) Suspected mechanisms for the left ventricular changes in the thalassemia HFpEF phenotype. Many circulating oxidative and inflammatory mediators damage the microvasculature, derange myocardial energetics, and promote interstitial fibrosis. Abbreviations: ANP, Atrial natriuretic peptide; BMP, B-type natriuretic peptide; HFpEF, heart failure with preserved ejection fraction.