Figure 4.

Findings of MVD and their associations within HFpEF. The presence of systemic microvascular dysfunction (MVD) in heart failure with preserved ejection fraction (HFpEF) is suggested by different clinical studies that show (1) cross-sectional microvascular differences between HFpEF and controls, (2) associations between baseline measures of microvascular function and incident HFpEF, and (3) associations between baseline microvascular measures in HFpEF patients and adverse disease progression defined by all-cause mortality or heart failure (HF) hospitalization. Due to current evidence limitations, causality between MVD and HFpEF requires further research.