Diastolic dysfunction in acute and critical illness: acute pathophysiology to chronic heart failure
Fisher, Tom Abbawy, Marcus Holden, Finlay Cotton, James Hothi, Sandeep Ingram, Thomas Dhamodaran, Kesaven Thilak, Suneesh Chacko, Cyril Gao-Smith, Fang
Fisher, Tom
Abbawy, Marcus
Holden, Finlay
Cotton, James
Hothi, Sandeep
Ingram, Thomas
Dhamodaran, Kesaven
Thilak, Suneesh
Chacko, Cyril
Gao-Smith, Fang
Affiliation
Other Contributors
Publication date
2026-01-13
Subject
Collections
Research Projects
Organizational Units
Journal Issue
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, Gao-Smith F, Veenith T. Diastolic Dysfunction in Acute and Critical Illness: Acute Pathophysiology to Chronic Heart Failure. JACC Adv. 2026 Jan 13;5(2):102532. doi: 10.1016/j.jacadv.2025.102532. Epub ahead of print.
Type
Article