Doctors and scientists race to understand a rising form of heart failure
Approximately 3 million people in the United States are living with a condition called heart failure with preserved ejection fraction, or HFpEF. The number of people with this form of heart failure, which is more common in women than men, is growing alongside a rise in risk factors like aging, hypertension, diabetes and obesity. Additionally, more than 80% of HFpEF patients also face pulmonary…
Heart failure with preserved ejection fraction (HFpEF) is a rising condition in the United States, affecting approximately 3 million people. This form of heart failure disproportionately impacts women and is associated with risk factors such as aging, hypertension, diabetes, and obesity. A significant number of HFpEF patients also suffer from pulmonary hypertension (PH), which can worsen the prognosis for these patients.
HFpEF is characterized by stiffened and thickened walls in the heart's left ventricle, leading to insufficient blood flow for daily activities and severe fatigue. The increased pressure in the heart can also damage the lungs and cause pulmonary hypertension, which further impairs breathing and contributes to debilitating symptoms, frequent hospitalizations, and a 15% annual mortality rate.
Although HFpEF is common, its early detection is challenging, and clinicians often fail to identify the disease in its treatable stage. This makes it difficult to accurately predict the prognosis of PH-HFpEF patients, who have additional complications like kidney failure, liver failure, and muscle mass loss. Recent clinical trials targeting pulmonary hypertension with drugs like sildenafil have also failed, highlighting the need for a more personalized approach to treatment.
A recent study led by cardiologist Farhan Raza at the University of Wisconsin–Madison has made progress in both detecting the severity of PH-HFpEF and understanding its underlying mechanisms. The researchers evaluated 48 PH-HFpEF patients and found that those with right ventricular (RV) dysfunction had higher mortality and hospitalization rates. RV function proved to be a better prognostic indicator than other methods currently used by clinicians.
The study also identified several biological pathways potentially involved in HFpEF, with diminished mitochondrial function being the most robust link. Additionally, there was an increase in RNA metabolism and transport, supporting previous research on the role of RNA metabolism and mitochondrial dysfunction in heart disease. These findings suggest that disrupted energy metabolism may be a crucial factor in the development of HFpEF.
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