Functional and Metabolic Imaging in Heart Failure with Preserved Ejection Fraction: Promises, Challenges, and Clinical Utility

Cardiovasc Drugs Ther. 2023 Apr;37(2):379-399. doi: 10.1007/s10557-022-07355-7. Epub 2022 Jul 26.

Abstract

Heart failure with preserved ejection fraction (HFpEF) is recognised as an increasingly prevalent, morbid and burdensome condition with a poor outlook. Recent advances in both the understanding of HFpEF and the technological ability to image cardiac function and metabolism in humans have simultaneously shone a light on the molecular basis of this complex condition of diastolic dysfunction, and the inflammatory and metabolic changes that are associated with it, typically in the context of a complex patient. This review both makes the case for an integrated assessment of the condition, and highlights that metabolic alteration may be a measurable outcome for novel targeted forms of medical therapy. It furthermore highlights how recent technological advancements and advanced medical imaging techniques have enabled the characterisation of the metabolism and function of HFpEF within patients, at rest and during exercise.

Keywords: C13; Cardiac metabolism; Diastolic dysfunction; HFpEF; Heart failure; Metabolic imaging; PET; Systematic review.

Publication types

  • Review

MeSH terms

  • Diagnostic Imaging
  • Exercise
  • Heart Failure* / diagnostic imaging
  • Heart Failure* / drug therapy
  • Humans
  • Stroke Volume
  • Ventricular Function, Left