Our perspective on heart failure with preserved ejection fraction (HFpEF) was designed to offer a past and present framework of this multifaceted disorder to enhance (expand) the dialogue between caregivers and investigators.1 Our major focus was on providing a context to better understand the emerging clinical trial and epidemiologic data. The pathophysiologic and compensatory mechanisms producing and responding to the elevated ventricular filling pressure, central to the signs and symptoms of heart failure across the spectrum of ejection fractions, were only briefly highlighted.
The complimentary comments from Drs. Nikolva, Hong and Shaw are appreciated as is their calling their recently published innovative study on the potential importance of cardiac bridging integrator 1 (cBIN1) as a possible biomarker of HFpEF to our attention.2,3 These types of productive exchanges are needed to continue to improve our understanding of this diverse disorder. Better mechanistic identification and stratification tools will undoubtedly facilitate more precision in future clinical trials. We hope our “in perspective” article will stimulate other interchanges to expand the discourse to better understand this complex heterogeneous disorder.
Disclosures:
Dr. Pfeffer receives research support from Novartis. He serves as a consultant for AstraZeneca, Corvidia, DalCor, GlaxoSmithKline, Novartis, Novo Nordisk, Roche, Sanofi, Servier and Takeda; and has equity in DalCor.
Dr. Shah is supported by NIH/NHLBI grants K08HL116792, R01HL135008, and R01HL143224. He receives research support through Brigham and Women’s Hospital from Novartis. He serves as a consultant from Bellerophon Therapeutics and Philips Ultrasound.
Dr. Borlaug is supported by the National Institutes of Health (R01 HL128526). No other relevant disclosures.
References:
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