Heart failure and left ventricular remodelling in HFrEF and HFpEF

Download the Issue @ a Glance podcast Subscribe to the EHJ Podcast ![Graphic][1] Due to the modern management of myocardial infarction and increasing longevity, heart failure has come to the centre stage in cardiovascular medicine.1 Thus, also in this past year numerous research projects have focused on this syndrome, and the most important ones are summarized for our readers by Michel Komajda from the CHU Pitie-Salpetriere in Paris, France in the review ‘ The year in cardiology 2015: heart failure ’.2 This contribution is followed by ‘ The year in cardiology 2015: valvular heart disease ’ by Bernard Iung from the Bichat Hospital.3 During this year a number of interesting articles addressed the topic of valvular heart disease with a special emphasis on imaging, interventions, and the publication of the new ESC Guidelines on the management of infective endocarditis (IE). An important chain of events leading to heart failure is hypertrophy, left ventricular dysfunction, and pump failure. In their clinical review ‘Heart failure: when form fails to follow function ’,4 Ellis L. Rolett and colleagues from the Dartmouth College Geisel School of Medicine in Hanover, New Hampshire, USA note that two hypertrophy phenotypes have been distinguished. One, systolic heart failure or heart failure with reduced ejection fraction (HFrEF), is characterized by ventricular dilatation and sarcomere addition in series. The other, also associated with a serious outcome,5 diastolic heart failure or heart failure with preserved ejection fraction (HFpEF), is characterized by concentric hypertrophy and sarcomere addition in parallel.6 Unlike the former, which increases wall stress and in turn initiates a vicious cycle that results in progressive dilatation … [1]: /embed/inline-graphic-1.gif