Aging and Heart Failure with Preserved Ejection Fraction

Larson, Kathryn F.; Malik, Awais Amjad; Brozovich, Frank V.

doi:10.1002/cphy.c210035

Cited by 6 publications

(5 citation statements)

References 127 publications

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“…HFpEF, traditionally attributed to left ventricular diastolic dysfunction, has been reported as the induction of a systemic pro‐inflammatory state. 10 A chronic pro‐inflammatory state, contributing to interstitial fibrosis, endothelial dysfunction, cardiac myocyte stiffening, and LV remodeling, appears to be the predominant pathophysiological mechanism in HFpEF. 11 , 12 Indeed, it has been demonstrated that increased inflammatory markers are associated with the development of HFpEF in elderly patients.…”

Section: Discussionmentioning

confidence: 99%

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Association between omentin‐1 and heart failure with preserved ejection fraction in Chinese elderly patients

Su,

Tian,

Liang

et al. 2023

Clinical Cardiology

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BackgroundOmentin‐1 is a novel adipokine and is associated with chronic inflammation and cardiovascular diseases. However, it remains unclear whether omentin‐1 levels are associated with diagnostic significance in elderly patients with heart failure with preserved ejection fraction (HFpEF). This study aimed to investigate the correlation between omentin‐1 and HFpEF in Chinese elderly patients.HypothesisOmentin‐1 may be invovled in HFpEF and there may be a difference of omentin‐1 levels between HFpEF and control.Methods217 subjects were selected, including 115 patients with HFpEF and 102 control subjects. Enzyme‐linked immuno sorbent assay (ELISA) was used to detect plasma levels of omentin‐1, tumor necrosis factor‐α (TNF‐α) and interleukin‐6 (IL‐6). The receiver operating characteristics (ROC) curve was used to examine the diagnostic performance of omentin‐1 in HFpEF.ResultsThe levels of omentin‐1 decreased significantly in the HFpEF group (14.02 ± 8.35 vs. 19.74 ± 8.45 ng/mL, p < .001), while NT‐proBNP, IL‐6, and TNF‐α levels were significantly increased in the HFpEF group compared with the control group. Spearman correlation analysis showed that omentin‐1 levels were negatively correlated with E/e' (r = −.340, p < .001). The multivariate logistic regression analysis indicated that omentin‐1 was an independent protective factor for HFpEF (odd ratio = 0.948, 95% confidence interval [CI] 0.905–0.993, p = .025). Omentin‐1 levels were negatively correlated with NT‐proBNP (r = −.273, p < .001) and TNF‐α (r = −.221, p = .001). Diagnostic efficiency by ROC curve analysis in the patients with HFpEF showed that the area under the curve (AUC) for omentin‐1 was equivalent to NT‐proBNP (AUC: 0.734, 95%CI 0.667–0.802; AUC: 0.800, 95%CI 0.738–0.861). Subgroup analysis showed that in the patients between the age of 70 and 80, the predictive capability of omentin‐1 was stronger than NT‐proBNP (AUC: 0.809, 95%CI 0.680–0.937; AUC: 0.674, 95%CI 0.514–0.833).ConclusionsOmentin‐1 levels which were associated with inflammation, were decreased in the HFpEF patients. It could be regarded as a valuable biomarker for the occurrence and development of HFpEF in elderly patients.

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Section: Discussionmentioning

confidence: 99%

“…HFpEF, traditionally attributed to left ventricular diastolic dysfunction, has been reported as the induction of a systemic proinflammatory state. 10 A chronic pro-inflammatory state, contributing…”

Section: Association Between Omentin-1 and Hfpef Diagnosismentioning

confidence: 99%

Association between omentin‐1 and heart failure with preserved ejection fraction in Chinese elderly patients

Su,

Tian,

Liang

et al. 2023

Clinical Cardiology

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“…In particular, heart failure with preserved ejection fraction (HFpEF), which is characterized by diastolic dysfunction, altered ventricular relaxation and filling, increased stiffness, and concentric cardiac remodeling (fibrosis, inflammation, and hypertrophy), represents one of the most complex and prevalent cardiometabolic diseases in the aging population [135][136][137]. HFpEF leads to pressure, but not volume overload, and is present frequently with comorbidities, such as advanced age, obesity, diabetes, and hypertension [138]. Most currently available drugs for HF show little or no effect on mortality rates in patients with HFpEF, confirmed by numerous clinical trials.…”

Section: Heartmentioning

confidence: 99%

Endothelial Senescence: From Macro- to Micro-Vasculature and Its Implications on Cardiovascular Health

Wang,

Konja,

Singh

et al. 2024

IJMS

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Endothelial cells line at the most inner layer of blood vessels. They act to control hemostasis, arterial tone/reactivity, wound healing, tissue oxygen, and nutrient supply. With age, endothelial cells become senescent, characterized by reduced regeneration capacity, inflammation, and abnormal secretory profile. Endothelial senescence represents one of the earliest features of arterial ageing and contributes to many age-related diseases. Compared to those in arteries and veins, endothelial cells of the microcirculation exhibit a greater extent of heterogeneity. Microcirculatory endothelial senescence leads to a declined capillary density, reduced angiogenic potentials, decreased blood flow, impaired barrier properties, and hypoperfusion in a tissue or organ-dependent manner. The heterogeneous phenotypes of microvascular endothelial cells in a particular vascular bed and across different tissues remain largely unknown. Accordingly, the mechanisms underlying macro- and micro-vascular endothelial senescence vary in different pathophysiological conditions, thus offering specific target(s) for therapeutic development of senolytic drugs.

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“…HFpEF is characterized by an increase in filling pressures caused by the complex interaction of multiple components, of which the concentric remodeling of the left ventricle (LV) is a relevant component [13]. It is well known that the increase in heart stiffness resulting from aging is an important cause of diastolic dysfunction; therefore, the general aging of the population concurs with a further increase in the prevalence of HFpEF in the coming decades [14]. Furthermore, the current lack of specific therapies for this condition will make HFpEF one of the most relevant issues to be addressed.…”

Section: Heart Failurementioning

confidence: 99%

Insulin Resistance/Hyperinsulinemia, Neglected Risk Factor for the Development and Worsening of Heart Failure with Preserved Ejection Fraction

Fazio,

Mercurio,

Fazio

et al. 2024

Biomedicines

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Heart failure (HF) has become a subject of continuous interest since it was declared a new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of different etiologies lead if not adequately treated. It is highly prevalent worldwide, with a progressive increase with age, reaching a prevalence of 10% in subjects over the age of 65 years. During the last two decades, it was possible to see that the prevalence of heart failure with preserved ejection fraction (HFpEF) was increasing while that of heart failure with reduced ejection fraction (HFrEF) was decreasing. HFpEF is typically characterized by concentric remodeling of the left ventricle (LV) with impaired diastolic function and increased filling pressures. Over the years, also the prevalence of insulin resistance (IR)/hyperinsulinemia (Hyperins) in the general adult population has progressively increased, primarily due to lifestyle changes, particularly in developed and developing countries, with a range that globally ranges between 15.5% and 46.5%. Notably, over 50% of patients with HF also have IR/Hyperins, and the percentage is even higher in those with HFpEF. In the scientific literature, it has been well highlighted that the increased circulating levels of insulin, associated with conditions of insulin resistance, are responsible for progressive cardiovascular alterations over the years that could stimulate the development and/or the worsening of HFpEF. The aim of this manuscript was to review the scientific literature that supports a pathophysiologic connection between IR/Hyperins and HFpEF to stimulate the scientific community toward the identification of hyperinsulinemia associated with insulin resistance as an independent cardiovascular risk factor in the development and worsening of HF, believing that its adequate screening in the general population and an appropriate treatment could reduce the prevalence of HFpEF and improve its progression.

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Aging and Heart Failure with Preserved Ejection Fraction

Cited by 6 publications

References 127 publications

Association between omentin‐1 and heart failure with preserved ejection fraction in Chinese elderly patients

Association between omentin‐1 and heart failure with preserved ejection fraction in Chinese elderly patients

Endothelial Senescence: From Macro- to Micro-Vasculature and Its Implications on Cardiovascular Health

Insulin Resistance/Hyperinsulinemia, Neglected Risk Factor for the Development and Worsening of Heart Failure with Preserved Ejection Fraction

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