HFpEF, aging, inflammaging, and the future of anti-inflammatory: therapy in heart failure with preserved ejection fraction

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Item Type:	Review
Title:	HFpEF, aging, inflammaging, and the future of anti-inflammatory: therapy in heart failure with preserved ejection fraction
Creators Name:	Grzeczka, Arkadiusz, Graczyk, Szymon, Gröschel, Jan, Spethmann, Sebastian and Kordowitzki, Pawel
Abstract:	Aging is the dominant risk factor for heart failure with preserved ejection fraction (HFpEF), a condition increasingly recognized as a manifestation of maladaptive cardiovascular aging. This review summarizes current evidence linking inflammaging, a chronic, low-grade inflammatory state driven by immunosenescence, mitochondrial dysfunction, and cellular senescence, to progressive myocardial fibrosis, diastolic stiffness, and HFpEF development. We discuss mechanistic pathways connecting fibroblast activation, extracellular matrix remodeling, adipose tissue-driven inflammation, and phenotype-specific inflammatory signatures, as well as the role of multimodality imaging in detecting early fibrotic and inflammatory changes. Finally, we critically evaluate emerging immunometabolic therapies, highlighting the limitations of single-cytokine blockade and the disease-modifying potential of SGLT2 inhibitors and GLP-1 receptor agonists in targeting HFpEF.
Keywords:	Cardiac Aging, Inflammaging, HFpEF, Cardiac Fibrosis
Source:	Aging and Disease
ISSN:	2152-5250
Publisher:	International Society on Aging and Disease
Date:	2 May 2026
Official Publication:	https://doi.org/10.14336/AD.2026.0265
PubMed:	View item in PubMed

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