How does inflammation in the hearts smallest blood vessels contribute to heart failure?

Microvascular inflammation in heart failure with preserved ejection fraction (HFpEF) (Dr Christopher Allen)

Researchers at St Thomas’ Hospital are trying to understand a form of heart failure that’s currently very hard to treat. Heart failure occurs when the heart can’t pump enough blood around the body and is a major cause of death and disability in the UK. In some cases the heart is still able to pump but the ventricles are stiff can’t relax properly, which means it doesn’t fill up with as much blood as it should. This means that less blood is pumped to the rest of the body. This is called ‘heart failure with preserved ejection fraction’ or HFpEF. Little is known about it, there are currently no effective treatments and it has a poor life expectancy. Ageing and conditions like diabetes, high blood pressure and obesity are risk factors for HFpEF. Scientists think this might be because these conditions induce inflammation in the microscopic blood vessels that supply blood to the heart muscle cells. This may make the cells stiffer and stop them from relaxing fully after each heartbeat. The team will measure blood flow and how well the heart pumps by placing wires inside the hearts of people with HFpEF, as well as taking microscopic samples of their heart tissue. They will investigate the effects of inflammation in the microvessels of the heart and the effect on the heart function of people with HFpEF. The team aims to shed light on the processes that lead to HFpEF to improve its diagnosis, and reveal new drug targets to develop new treatments.