The Interplay between Hyperaldosteronism and Heart Failure with Preserved Ejection Fraction: Pathophysiological Insights and Therapeutic Implications
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Abstract
Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome characterized by preserved left ventricular systolic function, diastolic dysfunction, and systemic inflammation, often coexisting with metabolic and hemodynamic disorders. Primary hyperaldosteronism (PHA), a condition marked by excessive aldosterone secretion, is increasingly recognized as a pivotal contributor to the pathophysiological mechanisms underpinning HFpEF. This review explores the intricate relationship between hyperaldosteronism and HFpEF, emphasizing the role of aldosterone in myocardial remodeling, endothelial dysfunction, and systemic inflammation. Additionally, it highlights emerging evidence on aldosterone antagonists as potential therapeutic agents in mitigating HFpEF-related morbidity. By integrating clinical findings with molecular insights, we aim to elucidate how hyperaldosteronism exacerbates HFpEF phenotypes and propose strategies for targeted management. This synthesis underscores the need for tailored interventions in patients with concomitant hyperaldosteronism and HFpEF.
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