Professor Dr. Mohammad Saif Ullah explains that heart failure with preserved ejection fraction (HFpEF) is not limited to weakened heart muscles or blocked arteries. According to a 2025 review published in JACC: Advances, HFpEF often stems from coronary microvascular dysfunction (CMD), a condition affecting the heart’s smallest blood vessels. Even when large coronary arteries appear normal, about three out of four HFpEF patients show signs of CMD, which silently worsens heart function.
The article notes that CMD prevents tiny vessels from supplying adequate blood, creating a vicious cycle where HFpEF and CMD aggravate each other. Women face higher risk due to smaller coronary vessels and reduced estrogen after menopause, which increases inflammation and stiffness in heart tissue. Despite available technology, CMD testing is rarely performed because no mandatory diagnostic guideline exists for HFpEF patients.
Current treatments such as SGLT2 inhibitors, statins, blood pressure control, lifestyle changes, and weight reduction offer partial relief. However, there is still no therapy directly targeting CMD, underscoring the need for a new clinical approach to this silent microvascular disease.
অধ্যাপক ডা. মোহাম্মদ সাইফ উল্লাহ প্রকাশ : ২৮ জানুয়ারি ২০২৬, ১২: ৪০ অধ্যাপক ডা. মোহাম্মদ সাইফ উল্লাহ হৃদরোগ মানেই কি শুধু হার্ট অ্যাটাক বা রক্তনালিতে বড় ব্লক? আধুনিক চিকিৎসাবিজ্ঞানের উত্তর এখন স্পষ্ট—না। হার্ট ফেইলিউর উইথ প্রিজার্ভড ইজেকশন ফ্র্যাকশন
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