{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:22:11Z","timestamp":1793532131967,"version":"4.5.0"},"reference-count":44,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Higher Education of the Republic of Kazakhstan, \u201cPathogenetic Significance of Structural and Functional Imbalance of the Vascular System in the Pulmonary-Cardiorenal Continuum\u201d","award":["AP 19676870"],"award-info":[{"award-number":["AP 19676870"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: This study aims to investigate the potential etiopathogenesis of HFpEF development and identify possible different phenotypes of HFpEF in patients with chronic obstructive pulmonary disease (COPD) and systemic sclerosis-associated interstitial lung diseases (SS-ILDs). It could help clinicians improve early HFpEF personalized detection and management. Methods: This study included 150 patients with chronic lung diseases (CLDs), such as COPD and SS-ILD, who were outside of exacerbation, had no history of chronic heart failure (CHF), and had a left ventricular ejection fraction (LV EF) of \u226550%. The functional status of the lungs, heart, endothelial dysfunction, and acid\u2013base balance was assessed. The results obtained were compared in groups of patients with CLD depending on the presence or absence of HF with preserved ejection fraction (HFpEF). The diagnosis of HFpEF was established based on the HFA-PEFF Score classification. Nonparametric statistical methods were used. Results: In patients with CLD, indicators such as age, longitudinal size of the right atrium, mid-regional pro-atrial natriuretic peptide (MR-proANP), and highly sensitive cardiac troponin T (hsTnT) were higher than in the group of patients without HFpEF. In patients with COPD and HFpEF, statistically significant changes were found in the volume of the left atrium. In patients with SS-ILD and HFpEF, statistically significant differenceswere found in SBP before and after the 6 min walk test (6MWT), the Borg scale before 6MWT, MR-proANP, and the longitudinal dimension of the right atrium. Conclusions: The results of our study allow us to identify two different mechanisms of HFpEF development: In patients with COPD, the predominant factor in the development of HFpEF was hypoxia, while in patients with SS-ILD, myocardial dysfunction with remodeling developed against the background of secondary pulmonary hypertension, highlighting the importance of phenotype-specific evaluation. These findings suggest potential approaches for personalized risk stratification and the development of targeted management strategies for patients with HFpEF.<\/jats:p>","DOI":"10.3390\/jpm15050206","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T04:48:18Z","timestamp":1747716498000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Features of Heart Failure with Preserved Ejection Fraction in Patients with Chronic Obstructive Pulmonary Disease and Systemic Sclerosis-Associated Interstitial Lung Diseases"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9917-0258","authenticated-orcid":false,"given":"Lyazat","family":"Ibrayeva","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4053-0260","authenticated-orcid":false,"given":"Meruyert","family":"Aubakirova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5576-8637","authenticated-orcid":false,"given":"Irina","family":"Bacheva","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-1506","authenticated-orcid":false,"given":"Assel","family":"Alina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4777-4620","authenticated-orcid":false,"given":"Nazira","family":"Bazarova","sequence":"additional","affiliation":[{"name":"Administration Department, Regional Clinical Hospital of Karaganda, Karaganda 100000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4221-9492","authenticated-orcid":false,"given":"Aizhan","family":"Zhanabayeva","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Avdiyenko","sequence":"additional","affiliation":[{"name":"Scientific Research Laboratory, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda","family":"Borchashvili","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saltanat","family":"Tazhikhanova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Askhat","family":"Murzabaeyev","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Karaganda Medical University, Karaganda 100012, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lin, C.H., Yeh, J.K., Lin, T.Y., Lo, Y.L., Chang, B.J., Ju, J.S., Chiu, T.H., Tung, P.H., Huang, Y.J., and Lin, S.M. (2023). Influence of chronic obstructive pulmonary disease on long-term hospitalization and mortality in patients with heart failure with reduced ejection fraction. BMC Pulm. Med., 23.","DOI":"10.1186\/s12890-023-02357-z"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e019238","DOI":"10.1161\/JAHA.121.021494","article-title":"Clinical characteristics and outcomes of patients with heart failure with reduced ejection fraction and chronic obstructive pulmonary disease: Insights from PARADIGM-HF","volume":"10","author":"Mooney","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zhu, A., Hu, M., Ge, D., Zhang, X., Zhang, J., Wang, Y., Yao, X., and Liu, J. (2025). Prevalence and clinical correlates of chronic obstructive pulmonary disease in heart failure patients: A cross-sectional study in China. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1477388"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"106800","DOI":"10.1016\/j.rmed.2022.106800","article-title":"Heart failure in patients with COPD exacerbations: Looking below the tip of the iceberg","volume":"196","author":"Hesse","year":"2022","journal-title":"Respir. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1002\/ehf2.15127","article-title":"Phenotyping patients with chronic obstructive pulmonary disease and heart failure","volume":"12","author":"Becher","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1017\/S1463423618000117","article-title":"Characteristics associated with mortality in patients with chronic obstructive pulmonary disease (COPD)-heart failure coexistence","volume":"19","author":"Plachi","year":"2018","journal-title":"Prim. Health Care Res. Dev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e021494","DOI":"10.1161\/JAHA.121.021494","article-title":"Impact of Chronic Obstructive Pulmonary Disease in Patients With Heart Failure With Preserved Ejection Fraction: Insights From PARAGON-HF","volume":"10","author":"Mooney","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","first-page":"e17387","article-title":"The Coexistence of Chronic Obstructive Pulmonary Disease and Heart Failure","volume":"13","author":"Khalid","year":"2021","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2217\/fca-2020-0238","article-title":"Prevalence and prognostic significance of heart failure with preserved ejection fraction in systemic sclerosis","volume":"18","author":"Oliveira","year":"2022","journal-title":"Future Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4102\/sajp.v77i1.1549","article-title":"Six-minute walk test protocol variations in low-resource settings\u2014A scoping review","volume":"77","author":"Fell","year":"2021","journal-title":"S. Afr. J. Physiother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3904\/kjim.2021.272","article-title":"HFA-PEFF scores: Prognostic value in heart failure with preserved left ventricular ejection fraction","volume":"37","author":"Egashira","year":"2022","journal-title":"Korean J. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1513\/AnnalsATS.202202-152ED","article-title":"Comorbid Chronic Obstructive Pulmonary Disease and Heart Failure: Shared Risk Factors and Opportunities to Improve Outcomes","volume":"19","author":"Khan","year":"2022","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/ehf2.14958","article-title":"Association of COPD with adverse outcomes in heart failure patients with preserved ejection fraction","volume":"12","author":"Xu","year":"2024","journal-title":"ESC Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.amjcard.2021.03.009","article-title":"Impact of chronic obstructive pulmonary disease in heart failure with preserved ejection fraction","volume":"149","author":"Jain","year":"2021","journal-title":"Am. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.hfc.2007.10.001","article-title":"Ventricular\u2013vascular interaction in heart failure","volume":"4","author":"Borlaug","year":"2008","journal-title":"Heart Fail. Clin."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"220173","DOI":"10.1183\/16000617.0173-2022","article-title":"Endotyping COPD: Hypoxia-inducible factor-2 as a molecular \u201cswitch\u201d between the vascular and airway phenotypes?","volume":"32","author":"Myronenko","year":"2023","journal-title":"Eur. Respir. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1186\/cc11475","article-title":"Oxygen-induced hypercapnia in COPD: Myths and facts","volume":"16","author":"Abdo","year":"2012","journal-title":"Crit. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3536","DOI":"10.1093\/cvr\/cvac133","article-title":"Inflammatory pathways in heart failure with preserved left ventricular ejection fraction: Implications for future interventions","volume":"118","author":"Pugliese","year":"2022","journal-title":"Cardiovasc. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Peh, Z.H., Dihoum, A., Hutton, D., Arthur, J.S.C., Rena, G., Khan, F., Lang, C.C., and Mordi, I.R. (2023). Inflammation as a therapeutic target in heart failure with preserved ejection fraction. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1125687"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Nakamura, K., Akagi, S., Ejiri, K., Taya, S., Saito, Y., Kuroda, K., Takaya, Y., Toh, N., Nakayama, R., and Katanosaka, Y. (2025). Pathophysiology of Group 3 Pulmonary Hypertension Associated with Lung Diseases and\/or Hypoxia. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26020835"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Barnes, P.J. (2022). Oxidative Stress in Chronic Obstructive Pulmonary Disease. Antioxidants, 11.","DOI":"10.3390\/antiox11050965"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"McGuinness, A.J.A., and Sapey, E. (2017). Oxidative stress in COPD: Sources, markers, and potential mechanisms. J. Clin. Med., 6.","DOI":"10.3390\/jcm6020021"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"00983","DOI":"10.1183\/23120541.00983-2020","article-title":"Endothelial dysfunction in COPD: A systematic review and meta-analysis of studies using different functional assessment methods","volume":"7","author":"Theodorakopoulou","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12931-019-1017-y","article-title":"The pathology of small airways disease in COPD: Historical aspects and future directions","volume":"20","author":"Higham","year":"2019","journal-title":"Respir. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"542769","DOI":"10.1155\/2012\/542769","article-title":"Lung compliance and chronic obstructive pulmonary disease","volume":"2012","author":"Papandrinopoulou","year":"2012","journal-title":"Pulm. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40749-015-0008-8","article-title":"Lung hyperinflation in COPD: Applying physiology to clinical practice","volume":"1","author":"Webb","year":"2015","journal-title":"COPD Res. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Screm, G., Mondini, L., Salton, F., Confalonieri, P., Trotta, L., Barbieri, M., Romallo, A., Galantino, A., Hughes, M., and Lerda, S. (2024). Vascular Endothelial Damage in COPD: Where Are We Now, Where Will We Go?. Diagnostics, 14.","DOI":"10.3390\/diagnostics14090950"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.37349\/emed.2023.00199","article-title":"The role of pulmonary vascular endothelium in chronic obstructive pulmonary disease (COPD): Does endothelium play a role in the onset and progression of COPD?","volume":"4","author":"Siragusa","year":"2023","journal-title":"Explor. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1016\/j.rmed.2015.06.005","article-title":"The role of pulmonary arterial stiffness in COPD","volume":"109","author":"Struthers","year":"2015","journal-title":"Respir. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"180057","DOI":"10.1183\/16000617.0057-2018","article-title":"Cardiovascular disease and COPD: Dangerous liaisons?","volume":"27","author":"Rabe","year":"2018","journal-title":"Eur. Respir. Rev."},{"key":"ref_31","first-page":"1015","article-title":"Left ventricular structure and remodeling in patients with COPD","volume":"11","author":"Calzi","year":"2016","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_32","first-page":"8","article-title":"Left ventricular concentric remodeling in COPD patients: A cross-sectional observational study","volume":"163","author":"Leonardi","year":"2024","journal-title":"Med. Clin. (Engl. Ed.)"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.healun.2024.02.1044","article-title":"Compartment-specific remodeling patterns in end-stage chronic obstructive pulmonary disease with and without severe pulmonary hypertension","volume":"43","author":"Zeder","year":"2024","journal-title":"J. Heart Lung Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Alvarado, A.C., and Pinsky, M.R. (2023). Cardiopulmonary interactions in left heart failure. Front. Physiol., 14.","DOI":"10.3389\/fphys.2023.1237741"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s10456-024-09910-2","article-title":"The role of vasculature and angiogenesis in respiratory diseases","volume":"27","author":"Ackermann","year":"2024","journal-title":"Angiogenesis"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Pulito-Cueto, V., Genre, F., L\u00f3pez-Mej\u00edas, R., Mora-Cuesta, V.M., Iturbe-Fern\u00e1ndez, D., Portilla, V., Mora-Gil, M.S., Ocejo-Vinyals, J.G., Gualillo, O., and Blanco, R. (2023). Endothelin-1 as a Biomarker of Idiopathic Pulmonary Fibrosis and Interstitial Lung Disease Associated with Autoimmune Diseases. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24021275"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e007249","DOI":"10.1161\/JAHA.117.007249","article-title":"Lung Function, Inflammation, and Endothelin-1 in Congenital Heart Disease\u2013Associated Pulmonary Arterial Hypertension","volume":"7","author":"Low","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2560","DOI":"10.1038\/s41467-023-38177-2","article-title":"Lung endothelial cells regulate pulmonary fibrosis through FOXF1\/R-Ras signaling","volume":"14","author":"Bian","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e013310","DOI":"10.1161\/JAHA.119.013310","article-title":"Hypoxic Pulmonary Vasoconstriction and the Diffusing Capacity in Pulmonary Hypertension Secondary to Idiopathic Pulmonary Fibrosis","volume":"8","author":"Sakao","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1186\/s12931-020-01570-2","article-title":"Pulmonary hypertension secondary to pulmonary fibrosis: Clinical data, histopathology and molecular insights","volume":"21","author":"Ruffenach","year":"2020","journal-title":"Respir. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3223","DOI":"10.1002\/ehf2.13448","article-title":"Grading right ventricular dysfunction in left ventricular disease using echocardiography: A proof of concept using a novel multiparameter strategy","volume":"8","author":"Astengo","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1007\/s10067-016-3279-9","article-title":"Right atrial morphology and function in patients with systemic sclerosis compared to healthy controls: A two-dimensional strain study","volume":"35","author":"Vettori","year":"2016","journal-title":"Clin. Rheumatol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Vos, J.L., Butcher, S.C., Fortuni, F., Galloo, X., Rodwell, L., Vonk, M.C., Bax, J.J., van Leuven, S.I., de Vries-Bouwstra, J.K., and Snoeren, M. (2022). The prognostic value of right atrial and right ventricular functional parameters in systemic sclerosis. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.845359"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Singh, A., Bhatt, K.S., Nguyen, H.C., Frisbee, J.C., and Singh, K.K. (2024). Endothelial-to-mesenchymal transition in cardiovascular pathophysiology. Int. J. Mol. Sci., 25.","DOI":"10.20944\/preprints202405.0888.v1"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/5\/206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:35:29Z","timestamp":1760031329000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/15\/5\/206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,20]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jpm15050206"],"URL":"https:\/\/doi.org\/10.3390\/jpm15050206","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,20]]}}}