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Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation
Author(s) -
ter Maaten Jozine M.,
Damman Kevin,
Verhaar Marianne C.,
Paulus Walter J.,
Duncker Dirk J.,
Cheng Caroline,
Heerebeek Loek,
Hillege Hans L.,
Lam Carolyn S.P.,
Navis Gerjan,
Voors Adriaan A.
Publication year - 2016
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.497
Subject(s) - medicine , endothelial dysfunction , heart failure with preserved ejection fraction , heart failure , cardiology , cardiorenal syndrome , inflammation , systemic inflammation , ejection fraction , fibrosis , endothelium , cardiac dysfunction , renal function
Renal dysfunction in heart failure with preserved ejection fraction ( HFpEF ) is common and is associated with increased mortality. Impaired renal function is also a risk factor for developing HFpEF . A new paradigm for HFpEF , proposing a sequence of events leading to myocardial remodelling and dysfunction in HFpEF , was recently introduced, involving inflammatory, microvascular, and cardiac components. The kidney might play a key role in this systemic process. Renal impairment causes metabolic and systemic derangements in circulating factors, causing an activated systemic inflammatory state and endothelial dysfunction, which may lead to cardiomyocyte stiffening, hypertrophy, and interstitial fibrosis via cross‐talk between the endothelium and cardiomyocyte compartments. Here, we review the role of endothelial dysfunction and inflammation to explain the link between renal dysfunction and HFpEF , which allows for identification of new early risk markers, prognostic factors, and unique targets for intervention.