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Diastolic dysfunction in acute and critical illness: acute pathophysiology to chronic heart failure
Fisher, Tom Abbawy, Marcus Holden, Finlay Hothi, Sandeep Ingram, Thomas Dhamodaran, Kesaven Thilak, Suneesh Chacko, Cyril Gao-Smith, Fang Gao
Fisher, Tom
Abbawy, Marcus
Holden, Finlay
Hothi, Sandeep
Ingram, Thomas
Dhamodaran, Kesaven
Thilak, Suneesh
Chacko, Cyril
Gao-Smith, Fang Gao
Editors
Other contributors
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Epub Date
Issue Date
2026-01-15
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Abstract
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous, multi-organ syndrome driven by comorbidity-induced systemic inflammation. In acute and critical illness, such as sepsis, acute diastolic dysfunction is common. Its prognostic significance is debated and is complicated by hemodynamic instability and diagnostic challenges. Survivors of acute illness face a long-term risk of major adverse cardiovascular events, yet the transition from critical illness to acquired diastolic dysfunction to chronic HFpEF remains an underexplored area requiring further research. Recent landmark trials have established new therapeutic options for chronic HFpEF, including sodium glucose co-transporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists. Here, we review the pathophysiology of HFpEF across the continuum from chronic stable HFpEF to acute decompensation, identify long-term sequelae, and highlight future advancements.
Citation
Fisher, T., Abbawy, M., Holden, F., Cotton, J., Hothi, S., Ingram, T., Dhamodaran, K., Thilak, S., Chacko, C., Smith, F.G., Veenith, T. (2026) Diastolic dysfunction in acute and critical illness: acute pathophysiology to chronic heart failure. JACC Advances, 5(2), 102532.
Publisher
Journal
Research Unit
PubMed ID
41534382 (pubmed)
PubMed Central ID
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Type
Journal article
Language
en
Description
© 2026 The Authors. Published by Elsevier/ American College of Cardiology. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1016/j.jacadv.2025.102532
Series/Report no.
ISSN
2772-963X
EISSN
2772-963X