title: Connecting heart failure with preserved ejection fraction and renal dysfunction: the role of endothelial dysfunction and inflammation.
abstract: 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.
authors: University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Jozine M
authors: JM
authors: Ter Maaten
authors: University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Kevin
authors: K
authors: Damman
authors: University Medical Center Utrecht, Department of Nephrology and Hypertension, Utrecht, The Netherlands.
authors: Marianne C
authors: MC
authors: Verhaar
authors: Department of Physiology, Cardiology, Pathology, and Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
authors: Walter J
authors: WJ
authors: Paulus
authors: Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors: Dirk J
authors: DJ
authors: Duncker
authors: University Medical Center Utrecht, Department of Nephrology and Hypertension, Utrecht, The Netherlands.|Experimental Cardiology, Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors: Caroline
authors: C
authors: Cheng
authors: Department of Physiology, Cardiology, Pathology, and Surgery, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
authors: Loek
authors: L
authors: van Heerebeek
authors: University of Groningen, Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Hans L
authors: HL
authors: Hillege
authors: National Heart Centre Singapore and, Duke-National University of Singapore Graduate School Medicine, Singapore.
authors: Carolyn S P
authors: CS
authors: Lam
authors: University of Groningen, Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Gerjan
authors: G
authors: Navis
authors: University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands.
authors: Adriaan A
authors: AA
authors: Voors
mesh_terms: D006332:Cardiomegaly / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006333:Heart Failure / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D009206:Myocardium / Q000276:immunology / Q000378:metabolism; D032383:Myocytes, Cardiac; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000276:immunology / Q000378:metabolism* / Q000503:physiopathology; D013318:Stroke Volume; D020257:Ventricular Remodeling
keywords: Endothelial dysfunction; Heart failure with preserved ejection fraction; Inflammation; Renal dysfunction