Phenotypes of Chronic Heart Failure in Patients with Preserved Ejection Fraction

Chronic heart failure with preserved ejection fraction (CHFpEF) is a common syndrome that leads to adverse outcomes. The syndrome is quite heterogeneous and, according to multiple clinical, genetic, molecular, proteomic, and other studies, varies significantly depending on the predominant pathophysiological mechanism. Currently, modern research methods, such as those for studying proteome, genome, and epicardial regulation, allow a more precise identification of phenotypes. This review focuses on existing concepts on phenotypes in CHFpEF, specifically, aseptic inflammation, myocardial fibrosis, dysmetabolism, and others. Data were searched using the PubMed search by keywords in the 2010-2025 time range using the following tags: HFpEF, phenotypes, proteome, metabolome, inflammation, fibrosis. Currently, a limited number of drugs is available for the treatment of CHFpEF. Potentially, identifying phenotypes in each individual patient will facilitate personalized therapy, such as anti-inflammatory therapy for those with a predominantly inflammatory component, antifibrotic therapy for those with a fibrotic phenotype, etc.

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