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. 2019 Sep 4;10:1108. doi: 10.3389/fphys.2019.01108

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Copyright © 2019 van de Wouw, Broekhuizen, Sorop, Joles, Verhaar, Duncker, Danser and Merkus.

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.

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A proposed schematic overview of the pathological mechanisms that underlie the progression of CKD to HFpEF. Blue box depicts renal factors; green box depicts coronary microvascular factors; and red box depicts myocardial changes contributing to HFpEF. AGEs, advanced glycation products; CKD, chronic kidney disease; EC, endothelial cell; FGF-23, fibroblast growth factor 23; HFpEF, heart failure with preserved ejection fraction; LV, left ventricle; NO, nitric oxide; RAAS, renin-angiotensin-aldosterone system; ROS, reactive oxygen species; VSMC, vascular smooth muscle cell.