Expanding the horizon of heart failure with Preserved Ejection Fraction (HFPEF): advancing knowledge and detection through novel approaches

This thesis aimed to perform research that enhances the care of patients with heart failure, specifically a type that more frequently occurs in women and is called heart failure with preserved ejection fraction (HFpEF) or diastolic heart failure. Approximately 250,000 individuals in the Netherlands have HFpEF. Treatment strategies were limited, and clinical diagnosis remained challenging. New insights that improve diagnosis or suggest new treatment strategies may improve patients' quality-of-life with HFpEF.
One focus of this thesis was on disease mechanisms, particularly the microcirculation (the smallest blood vessels). It found several microvascular differences throughout the body in patients with HFpEF compared to individuals without HFpEF, suggesting that HFpEF is a systemic syndrome. The microvasculature could be a target for specific treatments or disease monitoring in HFpEF. This thesis also evaluated the use of existing diagnostic algorithms by healthcare professionals, introduced digital webtools to improve their utilisation, and suggested a new diagnostic step to simplify HFpEF diagnosis. Overall, this thesis contributes to better diagnosis and characterisation for HFpEF, expanding the horizon for improved patient care strategies.