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Cardiology353 papers

Heart failure with improved ejection fraction

Last edited: 4/23/2026

Overview

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by impaired ventricular relaxation and filling despite normal or near-normal ejection fraction, often associated with comorbidities like obesity, atrial fibrillation, and metabolic disturbances 141033.

Diagnosis

  • Clinical Presentation: Dyspnea, exercise intolerance, and signs of fluid retention 12.
  • Echocardiography: Preserved ejection fraction (≥50%), evidence of diastolic dysfunction (e.g., elevated E/E' ratio) 626.
  • Hemodynamics: Elevated pulmonary capillary wedge pressure (PCWP) during exercise, limited response to nitroglycerin 2.
  • Invasive Testing: Left ventricular pressure-volume loops may aid in diagnosis in challenging cases 33.
  • Novel Biomarkers: Neutrophil percentage-to-albumin ratio, ST2, Galectin-3, NT-proBNP for prognostic stratification 31131.
  • Comorbidities: Assess for obesity, central adiposity, atrial fibrillation, and metabolic syndrome 13340.
  • Management

  • Lifestyle Modifications: Weight loss, exercise training (e.g., high-intensity interval training) 814.
  • Pharmacotherapy:
  • - SGLT2 Inhibitors: Dapagliflozin, empagliflozin (improve outcomes, possibly through cardio-renal interaction) 440. - GLP-1 Receptor Agonists: Semaglutide, tirzepatide (show promise in improving metabolic parameters and outcomes) 3040. - Neuroprotective Agents: Berberine (reduces atrial lipotoxicity and improves AF in HFpEF) 7.
  • Rate Control: Address chronotropic incompetence with appropriate pacing strategies 1441.
  • Targeted Therapies: Investigational agents like DSF, GLP-1R agonists, and vagal stimulation show potential 44455.
  • Special Populations

  • Obesity and Central Adiposity: Significant impact on HFpEF development and response to treatment 13340.
  • Elderly: Higher prevalence of chronotropic incompetence and comorbidities 1441.
  • Women: Menopause increases HFpEF incidence, highlighting estrogen deficiency and beyond 23.
  • Comorbidities: CKD and type 2 diabetes influence treatment efficacy and outcomes 4858.
  • Key Recommendations

  • Implement Lifestyle Interventions: Weight loss and structured exercise training to improve functional capacity and reduce symptoms (Evidence: Moderate) 814.
  • Consider SGLT2 Inhibitors: Use of sodium-glucose cotransporter 2 inhibitors for improved outcomes in HFpEF patients, especially those with metabolic comorbidities (Evidence: Moderate) 440.
  • Monitor and Manage Comorbidities: Address atrial fibrillation, obesity, and metabolic syndrome to mitigate HFpEF progression (Evidence: Moderate) 13348.
  • Evaluate Novel Therapies: Explore GLP-1 receptor agonists and other targeted therapies in clinical trials or emerging evidence (Evidence: Weak) 3055.
  • Use Biomarkers for Prognosis: Incorporate biomarkers like neutrophil percentage-to-albumin ratio and natriuretic peptides for risk stratification (Evidence: Moderate) 331.
  • References

    Showing 100 most recent of 269 indexed papers.

    1 Ariyaratnam JP, Elliott AD, Mishima RS, Dziano JK, Emami M, Howie JO et al.. Evaluating the Impact of Obesity and Epicardial Adiposity on the Presence of HFpEF in Patients With AF. JACC. Clinical electrophysiology 2026. link 2 Babb TG, Balmain BN, Tomlinson AR, Hynan LS, Levine BD, MacNamara JP et al.. Ventilatory limitation to exercise in patients with HFpEF and obesity: No room to breathe. Respiratory physiology & neurobiology 2026. link 3 Ömür SE, Karaman K, Zorlu Ç, Genç Tapar G. Neutrophil Percentage-to-Albumin Ratio as a Novel Predictor of Diuretic Resistance and Mortality in Patients with Heart Failure with Preserved Ejection Fraction. Anatolian journal of cardiology 2026. link 4 Masuda T, Kariro K, Morishita Y. Why are SGLT2 inhibitors effective in HFpEF? Implications for interstitial fluid retention and cardio-renal interaction. Hypertension research : official journal of the Japanese Society of Hypertension 2026. link 5 Pan Q, Chen C, Zhang C, Jiang Y, Zhou Z, Zhang H et al.. Small extracellular vesicle-mediated adipocyte-cardiomyocyte crosstalk exacerbates heart failure with preserved ejection fraction. Cardiovascular research 2026. link 6 Lin TT, Huang KC, Lin HH, Su MM, Lin LC, Lin LY et al.. Comprehensive cardiac magnetic resonance assessment of right ventricular and left atrial function for early diagnosis of heart failure with preserved ejection fraction. European radiology 2026. link 7 Cao Z, Duan J, Meng S, Zhou Z, Huang Y, Chen X et al.. Berberine Reduces Atrial Lipotoxicity and Endoplasmic Reticulum Stress to Alleviate Heart Failure With Preserved Ejection Fraction (HFpEF)-Associated Atrial Fibrillation via AMPK Signaling. Phytotherapy research : PTR 2026. link 8 Pino-De la Fuente F, Troncoso MF, Urquiza-Zurich S, Silva D, Díaz-Vesga MC, Jiménez-Gallegos D et al.. High-intensity interval training attenuates the progression of diastolic and skeletal muscle dysfunction in the two-hit mouse model of HFpEF. Life sciences 2026. link 9 Sun Q, Xu Y, Tan W, Yao Z, Ruan H, Yang Y et al.. Leveraging explainable machine learning models to predict moderate to severe obstructive sleep apnea in heart failure with preserved ejection fraction patients: A comorbidity perspective. International journal of cardiology 2026. link 10 Packer M. Evolutionary History of the Comorbidity-Driven Coronary Microvascular Endothelial Inflammation Hypothesis and Its Metamorphosis to the Adipokine Hypothesis of Heart Failure With a Preserved Ejection Fraction. JACC. Heart failure 2026. link 11 Pradeep Kundur S, Charavanamuttu Y, Manivannan K, Noori M, Muraleedharan C, Malik A. Ophthalmic insights into systemic microvascular dysfunction for early detection of HFpEF: a narrative review. Current medical research and opinion 2026. link 12 Li W, Shen X, Jiang X, Shen Y, Wen H, Zhang W et al.. Exploring the Role and Mechanism of DSF in HFpEF Based on IL-1β/IL-1βR/TAK1/RIPK1 Axis-Mediated PANoptosis. International heart journal 2026. link 13 Safarova AF, Kobalava ZD, Adam SB, Timofeeva TM. The Value of Rhythm Control in Atrial Functional Mitral Regurgitation Among Patients With Preserved Left Ventricular Ejection Fraction. Kardiologiia 2026. link 14 Palau P, de Amo I, Núñez G, Flor C, de la Espriella R, García-Conejo C et al.. Effect of exercise training in patients with chronotropic incompetence and heart failure with preserved ejection fraction: the TRAINING-HR randomized clinical trial. European journal of preventive cardiology 2026. link 15 Lin M, Li K, Wang X, Sun J, Gong K, Wang Z et al.. Peak strain dispersion as a nonlinear mediator in HFpEF: Unraveling subtype-specific pathways via SHAP-augmented ensemble modeling. PLoS computational biology 2026. link 16 Nakashima H, Shinohara K, Matsumoto S, Nakashima R, Yoshida D, Ono Y et al.. Establishment of a HFpEF model using female Dahl salt-sensitive rats: a valuable tool for elucidating the pathophysiology of HFpEF in women. Hypertension research : official journal of the Japanese Society of Hypertension 2025. link 17 Zhou Y, Han Y, Xie Y, Wang L, Zhang H, Chen R et al.. Association of the triglyceride glucose-body roundness index with mortality in HFpEF and effect modification by nutritional status: a multicenter prospective cohort study. Lipids in health and disease 2025. link 18 Wang Y, Wang Y, Luan Y, Hao M, Yin W, Wu B et al.. Multimodal Data-Driven Explainable Prognostic Model for Major Adverse Cardiovascular Events Prediction in Patients With Unstable Angina and Heart Failure With Preserved Ejection Fraction: Multicenter, Cross-Regional Cohort Study. Journal of medical Internet research 2025. link 19 La Fazia VM, Pierucci N, Mohanty S, Chiricolo G, Natale A. Atrial Fibrillation Ablation in Heart Failure with Preserved Ejection Fraction. Cardiac electrophysiology clinics 2025. link 20 Yamada Y, Sadahiro T, Nakano K, Honda S, Abe Y, Akiyama T et al.. Cardiac Reprogramming and Gata4 Overexpression Reduce Fibrosis and Improve Diastolic Dysfunction in Heart Failure With Preserved Ejection Fraction. Circulation 2025. link 21 Nguyen HT, Nguyen HLH, Lam VT, Huynh NK. Assessing Established Diagnostic Markers of HFpEF in Older Patients Presenting with Acute Dyspnoea in the Emergency Department. Vascular health and risk management 2025. link 22 Peng X, Li J, Liu N, He L, Liu X, Zhou N et al.. Varying effect of atrial fibrillation ablation in patients with heart failure with preserved ejection fraction according to CHA. Heart rhythm 2025. link 23 Methawasin M, Strom J, Marino VA, Gohlke J, Muldoon J, Herrick SR et al.. An ovary-intact postmenopausal HFpEF mouse model; menopause is more than just estrogen deficiency. American journal of physiology. Heart and circulatory physiology 2025. link 24 Dorsey NS, Baratto C, Prins KW, Atkins JL, Amoroso NS, Biscopink A et al.. Association of Moderate to Severe Tricuspid Regurgitation With Exercise Hemodynamics and Outcomes in Patients With Heart Failure With Preserved Ejection Fraction: Multicenter Study. Journal of cardiac failure 2025. link 25 Ibe T, Reddy YNV, Harada T, Doi S, Tada A, Naser JA et al.. Utility of HFpEF Diagnostic Scores to Stratify Cardiac Reserve Among Patients With Dyspnea. JACC. Heart failure 2025. link 26 Kürklü HA, Tan TS, Özyüncü N, Esenboğa K, Dinçer İ. Association Between Right Ventricular Echocardiographic Parameters and HFA-PEFF Score in Heart Failure with Preserved Ejection Fraction. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir 2025. link 27 Venkatesan T, Toumpourleka M, Niewiadomska M, Farhat K, Morris L, Elkholey K et al.. Vagal Stimulation Rescues HFpEF by Altering Cardiac Resident Macrophage Function. Circulation research 2025. link 28 Duan X, Zhang X, Sun B. The landscape of novel antidiabetic drugs in diabetic HFpEF: relevant mechanisms and clinical implications. Cardiovascular diabetology 2025. link 29 Dhont S, L'Hoyes W, Moura Ferreira S, Martens P, Stassen J, Claessen G et al.. Atrial Functional Mitral Regurgitation and Exercise-Induced Changes in Heart Failure With Preserved Ejection Fraction. JACC. Cardiovascular imaging 2025. link 30 Krüger N, Schneeweiss S, Fuse K, Matseyko S, Sreedhara SK, Hahn G et al.. Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction. JAMA 2025. link 31 Li P, Wang L, Yang F, Yu H, Xiao FK. Association of ST2, Galectin-3, and NT- Probnp in Elderly Hypertensive Patients and Heart Failure with a Preserved Ejection Fraction. Current vascular pharmacology 2025. link 32 Czulada E, Smith JD, Kolm P, Deb B, Dolman SF, Alexander N et al.. Rationale and Design of OPT-RATE AF: A Randomized Clinical Trial of Increased Physiologic Pacing Rates in Heart Failure With Preserved Ejection Fraction. The American journal of cardiology 2025. link 33 Zhang L, Feng L, Zhao Y, Geng Y, Liu R, Ma Y et al.. Lack of ALCAT1 enhances the protective effects of aerobic exercise on kidney in HFpEF mice. Life sciences 2025. link 34 Hullon D, Subeh GK, Volkova Y, Janiec K, Trach A, Mnevets R. The role of glucagon-like peptide-1 receptor (GLP-1R) agonists in enhancing endothelial function: a potential avenue for improving heart failure with preserved ejection fraction (HFpEF). Cardiovascular diabetology 2025. link 35 Algheffari J, Salameh AR, Adil L, Hameed A, Araz K. The role of neuromodulation in heart failure with preserved ejection fraction. Current problems in cardiology 2025. link 36 Hanatani S, Nakashima N, Ogata F, Yamamoto M, Okuno Y, Yamada T et al.. Mild transverse aortic constriction and continuous aldosterone administration induce heart failure with preserved ejection fraction. Biochemical and biophysical research communications 2025. link 37 Song YJ, Zhao XY, Wang LJ, Ning T, Chen MT, Liu P et al.. Epicardial Adipose Tissue and Heterogeneity Parameters Combined with Inflammatory Cells to Predict the Value of Heart Failure with Preserved Ejection Fraction Patients Post Myocardial Infarction. Cardiovascular diabetology 2025. link 38 Chen Q, Zhang H, Chen Y, Peng Y, Yao Y, Xue H et al.. Trimethylamine N-oxide induces cardiac diastolic dysfunction by down-regulating Piezo1 in mice with heart failure with preserved ejection fraction. Life sciences 2025. link 39 Longo S, Mollace R, Casagrande V, Bucciarelli L, Martelli E, Menghini R et al.. Glycometabolic cardiac dysfunction in HFpEF: Lessons from multi-omics studies. Pharmacological research 2025. link 40 Borlaug BA, Zile MR, Kramer CM, Ye W, Ou Y, Hurt K et al.. Impact of Body Mass Index, Central Adiposity, and Weight Loss on the Benefits of Tirzepatide in HFpEF: The SUMMIT Trial. Journal of the American College of Cardiology 2025. link 41 Lin TT, Chen TY, Cheng JF, Lin LY, Wu CK. Chronotropic Incompetence and Cardiovascular Outcomes in Patients With Heart Failure With Preserved Ejection Fraction. Journal of the American Heart Association 2025. link 42 Jia Y, Niu W, Liu L, Zhang Q, Li D, Dai T et al.. Succinate-GPR91 signaling promotes cardiomyocyte metabolic reprogramming and NAD. Cardiovascular diabetology 2025. link 43 Gessner R, Hübner AC, Stöbe S, Rudolph UM, Unger L, Schmeisser A et al.. Diagnosing HFpEF in Patients With Unexplained Dyspnea by Using Invasive Left Ventricular Pressure-Volume Loops. Journal of cardiac failure 2025. link 44 De Schutter S, Van Damme E, Van Hout G, Pype LL, Gevaert AB, Van Craenenbroeck EM et al.. Impact of Exercise on Atrial Functional Mitral Regurgitation and Its Determinants: An Exercise Echocardiographic Study. The American journal of cardiology 2025. link 45 Takahashi T, Wei J, Iribarren AC, Gulati M, Cook-Wiens G, Nelson MD et al.. Rationale and design of the women's ischemia syndrome evaluation mechanisms of coronary microvascular dysfunction leading to preheart failure with preserved ejection fraction (WISE Pre-HFPEF). American heart journal 2025. link 46 Okada M, Tanaka N, Iwakura K, Onishi T, Seo M, Yano M et al.. Left Atrial Volumetric/Mechanical Coupling Index in Heart Failure With Preserved Ejection Fraction. Journal of the American Heart Association 2025. link 47 Fonseka O, Raja R, Ross C, Gare SR, Zhang J, Hille SS et al.. XBP1s-EDEM2 Prevents the Onset and Development of HFpEF by Ameliorating Cardiac Lipotoxicity. Circulation 2025. link 48 Wang F, Huang W, Wang Z, Zhang D, Qiao H, Chen N et al.. Insulin resistance surrogates predict major adverse cardiovascular events in patients with heart failure with preserved ejection fraction and chronic kidney disease: a retrospective cohort study. Lipids in health and disease 2025. link 49 Fukui A, Hirota K, Mitarai K, Kondo H, Yamaguchi T, Shinohara T et al.. Efficacy and limitation of nonparoxysmal atrial fibrillation ablation in patients with heart failure with preserved ejection fraction. Journal of cardiovascular electrophysiology 2025. link 50 Packer M. The Adipokine Hypothesis of Heart Failure With a Preserved Ejection Fraction: A Novel Framework to Explain Pathogenesis and Guide Treatment. Journal of the American College of Cardiology 2025. link 51 Huang X, Liu X, Jiang Y, Cao Z, Wu M, Chen Z et al.. Association of Body Mass Index and Abdominal Obesity with Incidence of Atrial Fibrillation in Heart Failure with Preserved Ejection Fraction. Current medicinal chemistry 2025. link 52 Li C, Han X, He JK, Tang SX, Zhang YL, Yu XH et al.. FAP deficiency attenuates T2DM-associated HFpEF by suppressing the CaMKIIδ-Calcineurin A-NFATc2 signaling pathway. Clinical science (London, England : 1979) 2025. link 53 Kim SE, Yoo BS. Obesity and heart failure with preserved ejection fraction: focus on new drugs and future direction in medical treatment. The Korean journal of internal medicine 2025. link 54 Liu M, Lin J, Cai Y, He J, Lu M, Zhao Y et al.. Atrioventricular and Ventricular Mechanical Interdependence Assessment by Automated Function Imaging in Heart Failure With Preserved Ejection Fraction. Echocardiography (Mount Kisco, N.Y.) 2025. link 55 Li Z, Sun X, Wang Y, Zhang F, Wang L, Ai C et al.. Renal denervation attenuates cardiac dysfunction in HFpEF by inhibiting the ATP-P2X7-NLRP3 inflammasome axis. Basic research in cardiology 2025. link 56 Bonfioli GB, Rodella L, Metra M, Vizzardi E. GLP-1 receptor agonists as promising anti-inflammatory agents in heart failure with preserved ejection fraction. Heart failure reviews 2025. link 57 Hu X, Li D, Chen W, Kuang H, Yang D, Gong Z et al.. Sodium Glucose Transporter 2 Inhibitor Protects Against Heart Failure With Preserved Ejection Fraction: Preclinical "2-Hit" Model Reveals Autophagy Enhancement Via AMP-Activated Protein Kinase/Mammalian Target of Rapamycin Complex 1 Pathway. Journal of the American Heart Association 2025. link 58 Núñez-Marín G, Santas E. Cardiorenal Disease and Heart Failure with Preserved Ejection Fraction: Two Sides of the Same Coin. Cardiorenal medicine 2025. link 59 Earl J, Hart LA, Hansen RN. Identifying and characterizing commercially insured patients with HFpEF with high vs low health care resource utilization. Journal of managed care & specialty pharmacy 2025. link 60 Leahy MG, Wakeham DJ, MacNamara JP, Brazile T, Abulimiti A, Hearon CM et al.. Heart-Lung Interactions in HFpEF: Dynamic Hyperinflation and Exercise PCWP. JACC. Heart failure 2025. link 61 Balmain BN, Tomlinson AR, Goh JT, MacNamara JP, Wakeham DJ, Brazile TL et al.. Pulmonary gas exchange in relation to exercise pulmonary hypertension in patients with heart failure with preserved ejection fraction. The European respiratory journal 2025. link 62 Davies MJ, van der Meer P, Verma S, Patel S, Chinnakondepalli KM, Borlaug BA et al.. Semaglutide in obesity-related heart failure with preserved ejection fraction and type 2 diabetes across baseline HbA. The lancet. Diabetes & endocrinology 2025. link00304-8) 63 Cui X, Hu Y, Xu Y, Yang L, Chatterjee E, Li G et al.. Systemic Interactions in HFpEF: A Multiorgan Perspective on Pathways and Therapeutic Targets. Journal of cardiovascular translational research 2025. link 64 Lenormand T, Bisson A, Fauchier L. Heart failure with preserved ejection fraction and atrial fibrillation. Minerva medica 2025. link 65 Laufer-Perl M, Flint N, Arbel Y, Alenezi F, Kittipibul V, Yaranov D et al.. Atrial Mechanics in Heart Failure With Preserved Ejection Fraction: Effect of a No-Implant Interatrial Shunt. Circulation. Heart failure 2025. link 66 Nassiri S, Voordes GHD, van Heerebeek L, van Raalte DH, Verhaar MC, Touw DJ et al.. Effects of geranylgeranylacetone on diastolic and microvascular function in patients with heart failure with a preserved ejection fraction: A phase 2, randomized, placebo-controlled, crossover trial. European journal of heart failure 2025. link 67 Li S, Rodrigues PG, Chakraborty AD, Correia C, Schouten EM, Strömstedt M et al.. Nicotinamide-N-methyltransferase inhibition improves cardiac function and structure in a heart failure with preserved ejection fraction mouse model. Pharmacological research 2025. link 68 Wang M, Ren B, Wu X, Guo J, Cao Y, Men L et al.. S100A9 inhibition ameliorates HFpEF by modulating mitochondrial fission and oxidative stress. International immunopharmacology 2025. link 69 Lee S, Houstis NE, Cunningham TF, Brooks LC, Chen K, Slocum CL et al.. Transferrin Saturation Is a Better Predictor Than Ferritin of Metabolic and Hemodynamic Exercise Responses in HFpEF. JACC. Heart failure 2025. link 70 Subramanian M, Yalagudri S, Saggu DK, Dillikar M, Singh J, Bootla D et al.. Accelerated Bachmann bundle area pacing for atrial resynchronization in patients with non-obstructive hypertrophic cardiomyopathy and heart failure with preserved ejection fraction: A randomized crossover trial. Heart rhythm 2025. link 71 Lin M, Qin Y, Ding X, Zhang M, Zhu W, Guo D et al.. Association between Impaired Renal Function and Subclinical Myocardial Dysfunction in Patients with Heart Failure with Preserved Ejection Fraction: Assessment Using Noninvasive Pressure-Strain Loop. Cardiology 2024. link 72 Zhang LL, Chen GH, Tang RJ, Xiong YY, Pan Q, Jiang WY et al.. Levosimendan Reverses Cardiac Malfunction and Cardiomyocyte Ferroptosis During Heart Failure with Preserved Ejection Fraction via Connexin 43 Signaling Activation. Cardiovascular drugs and therapy 2024. link 73 Zhang JF, Pan YW, Li J, Kong XG, Wang M, Xue ZM et al.. Comparison of His-Purkinje Conduction System Pacing with Atrial-Ventricular Node Ablation and Pharmacotherapy in HFpEF Patients with Recurrent Persistent Atrial Fibrillation (HPP-AF study). Cardiovascular drugs and therapy 2024. link 74 Gudenkauf B, Shaya G, Mukherjee M, Michos ED, Madrazo J, Mathews L et al.. Insulin resistance is associated with subclinical myocardial dysfunction and reduced functional capacity in heart failure with preserved ejection fraction. Journal of cardiology 2024. link 75 Cheng JF, Huang PS, Chen ZW, Huang CY, Lan CW, Chen SY et al.. Post-exercise left atrial conduit strain predicted hemodynamic change in heart failure with preserved ejection fraction. European radiology 2024. link 76 Chen ZW, Chung YW, Cheng JF, Huang CY, Chen SY, Lin LY et al.. Right Ventricular-Vascular Uncoupling Predicts Pulmonary Hypertension in Clinically Diagnosed Heart Failure With Preserved Ejection Fraction. Journal of the American Heart Association 2024. link 77 He X, Bender M, Gross C, Narayanaswamy K, Laufer G, Jakubek S et al.. Left Atrial Decompression With the HeartMate3 in Heart Failure With Preserved Ejection Fraction: Virtual Fitting and Hemodynamic Analysis. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2024. link 78 Kresoja KP, Rosch S, Schöber AR, Fengler K, Schlotter F, Bombace S et al.. Implications of tricuspid regurgitation and right ventricular volume overload in patients with heart failure with preserved ejection fraction. European journal of heart failure 2024. link 79 Doiron JE, Li Z, Yu X, LaPenna KB, Quiriarte H, Allerton TD et al.. Early Renal Denervation Attenuates Cardiac Dysfunction in Heart Failure With Preserved Ejection Fraction. Journal of the American Heart Association 2024. link 80 Yoshida T, Yoshida S, Inukai K, Kato K, Yura Y, Hattori T et al.. ALPK2 prevents cardiac diastolic dysfunction in heart failure with preserved ejection fraction. FASEB journal : official publication of the Federation of American Societies for Experimental Biology 2024. link 81 Egami Y, Kobayashi N, Sugino A, Abe M, Osuga M, Nohara H et al.. Is sinus rhythm maintenance after repeat catheter ablation effective in patients with atrial fibrillation and heart failure with preserved ejection fraction?. Journal of cardiovascular electrophysiology 2024. link 82 Ababei A, Hrib LA, Iancu AC, Hadarag AV, Khebbaiz A, Vătășescu R et al.. Anti-bradycardia pacing-impact on patients with HFpEF: a systematic review. Heart failure reviews 2024. link 83 Abudureyimu M, Luo X, Jiang L, Jin X, Pan C, Yu W et al.. FBXL4 protects against HFpEF through Drp1-Mediated regulation of mitochondrial dynamics and the downstream SERCA2a. Redox biology 2024. link 84 Verwerft J, Stassen J, Falter M, Bekhuis Y, Hoedemakers S, Gojevic T et al.. Clinical Significance of Exercise Pulmonary Hypertension With a Negative Diastolic Stress Test for Suspected Heart Failure With Preserved Ejection Fraction. Journal of the American Heart Association 2024. link 85 Fu Z, Wang Y, Wang Y, Shi S, Li Y, Zhang B et al.. Linking abnormal fat distribution with HFpEF and diastolic dysfunction: a systematic review, meta-analysis, and meta-regression of observational studies. Lipids in health and disease 2024. link 86 Zhou R, Xia YY, Li Z, Wu LD, Shi Y, Ling ZY et al.. HFpEF as systemic disease, insight from a diagnostic prediction model reminiscent of systemic inflammation and organ interaction in HFpEF patients. Scientific reports 2024. link 87 Reddy YNV, Noseworthy P, Borlaug BA, Albert NM. Screening for Unrecognized HFpEF in Atrial Fibrillation and for Unrecognized Atrial Fibrillation in HFpEF. JACC. Heart failure 2024. link 88 Capone F, Nambiar N, Schiattarella GG. Beyond Weight Loss: the Emerging Role of Incretin-Based Treatments in Cardiometabolic HFpEF. Current opinion in cardiology 2024. link 89 Schulz A, Schellinger IN, Backhaus SJ, Adler AS, Lange T, Evertz R et al.. Association of Cardiac MRI-derived Aortic Stiffness with Early Stages and Progression of Heart Failure with Preserved Ejection Fraction. Radiology. Cardiothoracic imaging 2024. link 90 You H, Gou Q, Dong M, Chang F, Xiu J. Exploring the role of iNOS in HFpEF-Related myocardial fibrosis: Involvement of PTEN-PI3K/AKT signaling pathway. Biochemical and biophysical research communications 2024. link 91 Takizawa D, Harada T, Obokata M, Kagami K, Sorimachi H, Yuasa N et al.. Pathophysiologic and prognostic importance of cardiac power output reserve in heart failure with preserved ejection fraction. European heart journal. Cardiovascular Imaging 2024. link 92 Kitzman DW, Lewis GD, Pandey A, Borlaug BA, Sauer AJ, Litwin SE et al.. A novel controlled metabolic accelerator for the treatment of obesity-related heart failure with preserved ejection fraction: Rationale and design of the Phase 2a HuMAIN trial. European journal of heart failure 2024. link 93 Nan Tie E, Nanayakkara S, Vizi D, Mariani J, Kaye DM. The Impact of Diabetes on Haemodynamic and Cardiometabolic Responses in Heart Failure With Preserved Ejection Fraction. Heart, lung & circulation 2024. link 94 Sun Y, Li J, Zhang X, Wang N, Liu Y. RNA Sequencing Screens the Key Genes and Pathways in a Mouse Model of HFpEF. Journal of vascular research 2024. link 95 Jheng JR, Bai Y, Noda K, Huot JR, Cook T, Fisher A et al.. Skeletal Muscle SIRT3 Deficiency Contributes to Pulmonary Vascular Remodeling in Pulmonary Hypertension Due to Heart Failure With Preserved Ejection Fraction. Circulation 2024. link 96 Li S, Withaar C, Rodrigues PG, Zijlstra SN, de Boer RA, Silljé HHW et al.. The NLRP3-inflammasome inhibitor MCC950 improves cardiac function in a HFpEF mouse model. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 2024. link 97 Lau D. In HFpEF with obesity, semaglutide improved health status and weight loss at 52 wk, regardless of initial health status. Annals of internal medicine 2024. link 98 Harada T, Naser JA, Tada A, Doi S, Ibe T, Pislaru SV et al.. Cardiac function, haemodynamics, and valve competence with exercise in patients with heart failure with preserved ejection fraction and mild to moderate secondary mitral regurgitation. European journal of heart failure 2024. link 99 Minamisawa M, Inciardi RM, Claggett B, Cikes M, Liu L, Prasad N et al.. Clinical implications of subclinical left ventricular dysfunction in heart failure with preserved ejection fraction: The PARAGON-HF study. European journal of heart failure 2024. link 100 Zhang H, Gao Y, Zhang M, Yuan Z, Chen Y, Wang A et al.. Schaftoside improves HFpEF through regulation the autophagy-lysosome pathway by allosterically targeting CaMKII-δ. Redox biology 2024. link

    Original source

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      Evaluating the Impact of Obesity and Epicardial Adiposity on the Presence of HFpEF in Patients With AF.Ariyaratnam JP, Elliott AD, Mishima RS, Dziano JK, Emami M, Howie JO et al. JACC. Clinical electrophysiology (2026)
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      Ventilatory limitation to exercise in patients with HFpEF and obesity: No room to breathe.Babb TG, Balmain BN, Tomlinson AR, Hynan LS, Levine BD, MacNamara JP et al. Respiratory physiology & neurobiology (2026)
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      Why are SGLT2 inhibitors effective in HFpEF? Implications for interstitial fluid retention and cardio-renal interaction.Masuda T, Kariro K, Morishita Y Hypertension research : official journal of the Japanese Society of Hypertension (2026)
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      Small extracellular vesicle-mediated adipocyte-cardiomyocyte crosstalk exacerbates heart failure with preserved ejection fraction.Pan Q, Chen C, Zhang C, Jiang Y, Zhou Z, Zhang H et al. Cardiovascular research (2026)
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      High-intensity interval training attenuates the progression of diastolic and skeletal muscle dysfunction in the two-hit mouse model of HFpEF.Pino-De la Fuente F, Troncoso MF, Urquiza-Zurich S, Silva D, Díaz-Vesga MC, Jiménez-Gallegos D et al. Life sciences (2026)
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      Exploring the Role and Mechanism of DSF in HFpEF Based on IL-1β/IL-1βR/TAK1/RIPK1 Axis-Mediated PANoptosis.Li W, Shen X, Jiang X, Shen Y, Wen H, Zhang W et al. International heart journal (2026)
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      Peak strain dispersion as a nonlinear mediator in HFpEF: Unraveling subtype-specific pathways via SHAP-augmented ensemble modeling.Lin M, Li K, Wang X, Sun J, Gong K, Wang Z et al. PLoS computational biology (2026)
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