A Targeted Treatment Opportunity for HFpEF: Taking Advantage of Diastolic Tone

Abstract

PDE3 inhibition and pacing result in an increase in Ca2+- dependent myofilament activation resulting in a leftward movement of the pressure-volume loop and smaller LV volumes. Thus, the ventricle begins to fill at a smaller volume and spends more of its filling on the flatter, nonexponential segment of the diastolic PVR, whereas a prolongation of diastole with heart rate–lowering drugs may do the opposite.