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A large amount of preclinical evidence suggests that immune cells and their associated cytokines play important roles in mediating fibrosis, oxidative stress, metabolic derangements, and endothelial dysfunction, all potentially important processes in HFpEF. How inflammation contributes to HFpEF pathogenesis, however, remains poorly understood. Recently, a variety of preclinical models have emerged which may yield much needed insights into the causal relationships between risk factors and the development of HFpEF, including the role of specific immune cell subsets or inflammatory pathways. Here, we review evidence in animal models and humans implicating inflammation as a mediator of HFpEF and identify gaps in knowledge requiring further study. As the understanding between inflammation and HFpEF evolves, it is hoped that a better understanding of the mechanisms underlying immune cell activation in HFpEF can open up new therapeutic avenues.<\/jats:p>","DOI":"10.1042\/cs20230226","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T10:10:59Z","timestamp":1692699059000},"page":"1225-1247","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The immunology of heart failure with preserved ejection fraction"],"prefix":"10.1042","volume":"137","author":[{"given":"Charles\u00a0Duncan","family":"Smart","sequence":"first","affiliation":[{"name":"1Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena\u00a0S.","family":"Madhur","sequence":"additional","affiliation":[{"name":"1Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, U.S.A."},{"name":"2Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, U.S.A."},{"name":"3Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, U.S.A."},{"name":"4Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"key":"2023082210102105300_B1","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.jchf.2019.09.009","article-title":"Clinical phenogroups in heart failure with preserved ejection fraction: detailed phenotypes, prognosis, and response to spironolactone","volume":"8","author":"Cohen","year":"2020","journal-title":"JACC Heart Fail."},{"key":"2023082210102105300_B2","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1161\/CIRCULATIONAHA.114.010637","article-title":"Phenomapping for novel classification of heart failure with preserved ejection fraction","volume":"131","author":"Shah","year":"2015","journal-title":"Circulation"},{"key":"2023082210102105300_B3","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association","volume":"145","author":"Tsao","year":"2022","journal-title":"Circulation"},{"key":"2023082210102105300_B4","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/j.jchf.2018.03.006","article-title":"Temporal trends in the incidence of and mortality associated with heart failure with preserved and reduced ejection fraction","volume":"6","author":"Tsao","year":"2018","journal-title":"JACC Heart Fail."},{"key":"2023082210102105300_B5","doi-asserted-by":"publisher","first-page":"m2688","DOI":"10.1136\/bmj.m2688","article-title":"Heterogeneous trends in burden of heart disease mortality by subtypes in the United States, 1999-2018: observational analysis of vital statistics","volume":"370","author":"Shah","year":"2020","journal-title":"BMJ"},{"key":"2023082210102105300_B6","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1046\/j.1365-2796.1997.129150000.x","article-title":"Congestive heart failure in old age: prevalence, mechanisms and 4-year prognosis in the Helsinki Ageing Study","volume":"241","author":"Kupari","year":"1997","journal-title":"J. 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