Figure 1.

Vascular sympathetic neurotransmission and endothelial dysfunction in HFpEF. Enhanced sympathetic outflow led to increased release of norepinephrine (NE), which impair cardiovascular endothelial function by modifying peptides and signaling molecules that regulate perfusion to vascular beds. Endothelial uncoupling, in turn, can generate cardiomyocyte dysfunction that affects the structure and function of the heart through mechanisms associated with impaired myocardial dilatation capacity, stiffness, and inflammation.