Fig. (1).

Comorbidities commonly present in patients with HFpEF cause a chronic inflammatory state, which leads to an increase in fibrosis and myocardial stiffness, two characteristics of left ventricle (LV) dysfunction. Recently, it has been proposed that this chronic inflammatory state could also directly lead to coronary microvascular dysfunction (CMD), which would consequently lead to higher levels of inflammation, which may be further exacerbated by a pathological activation of hyaluronan (HA) - CD44 axis (A higher resolution / colour version of this figure is available in the electronic copy of the article).