Microvascular and lymphatic dysfunction in HFpEF and its associated comorbidities

被引：87

作者：

Cuijpers, Ilona ^{[1
,2
]}

Simmonds, Steven J. ^{[1
]}

van Bilsen, Marc ^{[3
]}

Czarnowska, Elibieta ^{[4
]}

Miqueo, Arantxa Gonzalez ^{[5
,6
]}

Heymans, Stephane ^{[1
,2
,7
]}

Kuhn, Annika R. ^{[3
]}

Mulder, Paul ^{[8
]}

Ratajska, Anna ^{[9
]}

Jones, Elizabeth A., V ^{[1
,2
]}

Brakenhielm, Ebba ^{[8
]}

机构：

[1] Katholieke Univ Leuven, Ctr Mol & Vasc Biol, Herestr 49, B-3000 Leuven, Belgium

[2] Maastricht Univ, Cardiovasc Res Inst Maastricht Car, Dept Cardiol, Univ Singel 50, NL-6229 ER Maastricht, Netherlands

[3] Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Dept Physiol, Univ Singel 50, NL-6229 ER Maastricht, Netherlands

[4] Childrens Mem Hlth Inst, Dept Pathol, Aleja Dzieci Polskich 20, PL-04730 Warsaw, Poland

[5] Univ Navarra, Program Cardiovasc Dis, Ctr Invest Med Aplicada CIMA, IdiSNA, Avda Pio XII 55, Pamplona 31008, Spain

[6] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Av Monforte de Lemos 3-5, Madrid 28029, Spain

[7] Netherlands Heart Inst, Holland Heart House,Moreelsepk 1, NL-3511 Utrecht, Netherlands

[8] Normandy Univ, Inst Natl Sante & Rech Med Inserm, UMR1096, Fac Med & Pharm, 22 Blvd Gambetta, F-76183 Rouen, France

[9] Med Univ Warsaw, Dept Pathol, Chalubinskiego 5, PL-02004 Warsaw, Poland

来源：

BASIC RESEARCH IN CARDIOLOGY | 2020年 / 115卷 / 04期

关键词：

Heart failure with preserved ejection fraction; Coronary microvascular dysfunction; Cardiac lymphatic dysfunction; Inflammation; Myocardial fibrosis; Cardiac metabolism; PRESERVED EJECTION FRACTION; VENTRICULAR DIASTOLIC DYSFUNCTION; MYOCARDIAL SUBSTRATE METABOLISM; OBSTRUCTIVE PULMONARY-DISEASE; OXIDE SYNTHASE EXPRESSION; ENDOTHELIAL GROWTH-FACTOR; HEART-FAILURE; VASCULAR-PERMEABILITY; OXIDATIVE STRESS; CARDIAC LYMPHANGIOGENESIS;

D O I：

10.1007/s00395-020-0798-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Heart failure with preserved ejection fraction (HFpEF) is a complex heterogeneous disease for which our pathophysiological understanding is still limited and specific prevention and treatment strategies are lacking. HFpEF is characterised by diastolic dysfunction and cardiac remodelling (fibrosis, inflammation, and hypertrophy). Recently, microvascular dysfunction and chronic low-grade inflammation have been proposed to participate in HFpEF development. Furthermore, several recent studies demonstrated the occurrence of generalized lymphatic dysfunction in experimental models of risk factors for HFpEF, including obesity, hypercholesterolaemia, type 2 diabetes mellitus (T2DM), hypertension, and aging. Here, we review the evidence for a combined role of coronary (micro)vascular dysfunction and lymphatic vessel alterations in mediating key pathological steps in HFpEF, including reduced cardiac perfusion, chronic low-grade inflammation, and myocardial oedema, and their impact on cardiac metabolic alterations (oxygen and nutrient supply/demand imbalance), fibrosis, and cardiomyocyte stiffness. We focus primarily on HFpEF caused by metabolic risk factors, such as obesity, T2DM, hypertension, and aging.

引用

页数：15

共 136 条

[1] The lymphatic vasculature in disease [J].