Paving the way for improved management of heart failure with preserved ejection fraction: The role of microvascular dysfunction and comorbidities

Heart failure with a stiff heart affects more than 100,000 people in the Netherlands. These patients experience many health problems, are frequently hospitalised, and have a shorter life expectancy.
This thesis aimed to improve our understanding of heart failure with a stiff heart and to contribute to ongoing efforts to improve treatments for these patients. This condition is not only a heart problem. In this type of heart failure the smallest blood vessels often do not function properly, both in the heart and in the rest of the body. This thesis shows that drugs, such as the diabetes drug empagliflozin, can improve the function of these tiny blood vessels, although not all patients may experience the same benefit from this treatment.

Heart failure with a stiff heart is also often accompanied by other health problems, such as diabetes, obesity, high blood pressure, and sleep issues. This thesis shows that these conditions are still frequently overlooked and emphasizes the importance of identifying and treating these conditions that can worsen heart failure. Simple tests, such as overnight oxygen measurements and electrocardiograms, can help identify patients at higher risk of worse outcomes. The findings of this research are valuable for guiding future studies and developing more personalised treatments for patients with heart failure with a stiff heart.