The treatment of selected traditional Chinese medicine prescriptions and their metabolites for heart failure with preserved ejection fraction from basic science discovery to the clinic

Abstract

The prevalence of heart failure with preserved ejection fraction (HFpEF) continues to rise worldwide. Compared with heart failure with reduced ejection fraction, HFpEF is associated with significant morbidity and mortality, yet only a limited number of treatment options have been proven effective. This narrative review aims to summarize the pathophysiological mechanisms of HFpEF and the pharmacological therapeutic strategies for this condition. Through a search of relevant literature from PubMed, VIP, Wanfang Data, and CNKI, basic research and clinical data on HFpEF were collected. The process involved examining and analyzing research on mechanisms and treatments of HFpEF. Based on both basic research and clinical data, this paper discussed the key roles of anti-inflammatory effects, anti-oxidant effects, and the reversal of mitochondrial dysfunction in improving cardiac remodeling, cardiac dysfunction and exercise intolerance in HFpEF. Furthermore, the paper suggested that Traditional Chinese Medicine (TCM), including metabolites and prescriptions, may serve as a potential therapeutic strategy for HFpEF and some prescriptions may serve as a potential adjuvant to guideline-directed medical therapy. In the future, it is hoped that the prognosis for patients with HFpEF by promoting the usage of TCM can be improved.