Renal Dysfunction and Heart Failure with Preserved Ejection Fraction

Manjula G Ananthram; Stephen S Gottlieb

doi:10.1016/j.hfc.2021.03.005

Renal Dysfunction and Heart Failure with Preserved Ejection Fraction

Heart Fail Clin. 2021 Jul;17(3):357-367. doi: 10.1016/j.hfc.2021.03.005.

Authors

Manjula G Ananthram¹, Stephen S Gottlieb²

Affiliations

¹ Department of Internal Medicine, Division of Cardiology, University of Maryland, 110 South Paca Street, 7th Floor, Baltimore, MD 21201, USA. Electronic address: [email protected].
² Department of Internal Medicine, Division of Cardiology, University of Maryland, 110 South Paca Street, 7th Floor, Baltimore, MD 21201, USA.

PMID: 34051968
DOI: 10.1016/j.hfc.2021.03.005

Abstract

Heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD) constitute a high-risk phenotype with significant morbidity and mortality and poor prognosis. Multiple proinflammatory comorbid conditions influence the pathogenesis of HFpEF and CKD. Renal dysfunction in HFpEF is a consequence of the complex interplay between hemodynamic factors, systemic congestion, inflammation, endothelial dysfunction, and neurohormonal mechanisms. In contrast to heart failure with reduced ejection fraction, there is a dearth of effective targeted therapies for HFpEF. Tailoring study design toward the different phenotypes and delving into their pathophysiology may be fruitful in development of effective phenotype-specific targeted pharmaceutical therapies.

Keywords: CKD; Cardiorenal syndrome; HFpEF; Heart failure with preserved ejection fraction; Renal dysfunction; Renal impairment.

Publication types

Review

MeSH terms

Glomerular Filtration Rate / physiology*
Heart Failure / complications*
Heart Failure / physiopathology
Humans
Renal Insufficiency, Chronic / etiology*
Renal Insufficiency, Chronic / physiopathology
Risk Factors
Stroke Volume / physiology*