Metabolic inflammation in heart failure with preserved ejection fraction

Cardiovasc Res. 2021 Jan 21;117(2):423-434. doi: 10.1093/cvr/cvaa217.

Abstract

One in 10 persons in the world aged 40 years and older will develop the syndrome of HFpEF (heart failure with preserved ejection fraction), the most common form of chronic cardiovascular disease for which no effective therapies are currently available. Metabolic disturbance and inflammatory burden contribute importantly to HFpEF pathogenesis. The interplay within these two biological processes is complex; indeed, it is now becoming clear that the notion of metabolic inflammation-metainflammation-must be considered central to HFpEF pathophysiology. Inflammation and metabolism interact over the course of syndrome progression, and likely impact HFpEF treatment and prevention. Here, we discuss evidence in support of a causal, mechanistic role of metainflammation in shaping HFpEF, proposing a framework in which metabolic comorbidities profoundly impact cardiac metabolism and inflammatory pathways in the syndrome.

Keywords: HFpEF; Immunity; Inflammation; Metabolism; Obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Comorbidity
  • Energy Metabolism*
  • Female
  • Heart Failure / drug therapy
  • Heart Failure / immunology
  • Heart Failure / metabolism*
  • Heart Failure / physiopathology
  • Humans
  • Inflammation / drug therapy
  • Inflammation / immunology
  • Inflammation / metabolism*
  • Inflammation / physiopathology
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / metabolism*
  • Male
  • Myocardium / immunology
  • Myocardium / metabolism*
  • Obesity / drug therapy*
  • Obesity / immunology
  • Obesity / metabolism
  • Obesity / physiopathology
  • Signal Transduction
  • Stroke Volume
  • Ventricular Function, Left*

Substances

  • Anti-Inflammatory Agents
  • Inflammation Mediators