Diastolic Heart Failure HFpEF Belgium 2025: NF-kB Cardiomyocytes, SGLT2 & Ginger

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WETENSCHAPPELIJKE SAMENVATTING

Hartfalen met behouden ejectiefractie (HFpEF / diastolisch hartfalen) vertegenwoordigt 50% van de hartfalengevallen in Belgie en neemt toe met de obesitas- en diabetes-type2-bloedsuiker-verlagen-belgie">gember diabetes-epidemie. Anders dan systolisch hartfalen est de LVEF normaal (>50%) maar de linker ventrikel est rigid en vult zich niet correct. Central mechanism: obesity/diabetes -> systemic heart disease (NF-kB, NLRP3) -> myocardial fibrosis (TGF-beta, collagen I/III) -> ventricular rigidity -> poor blood pressure -> congestive symptoms. Weg metabolism: hyperglycemia + AGE's -> RAGE -> cardiomyocyte NF-kB -> mitochondriaal oxidatief cortisol-natural-relief">stress (mtROS) -> diastolic dysfunction. SGLT2 (empagliflozin, dapagliflozin) is a possible source of HFpEF: via AMPK -> NF-kB omlaag -> fibroseresis. 6-Gingerol: cardiomyocyte NF-kB -40%, TGF-beta -32% (fibrosis), NLRP3 -38%, mtROS -30%. GIMBER = versnelde hartfibrosis: 35g suiker/100ml -> AGE's -> RAGE -> NF-kB -> TGF-beta -> fibrosis -> verergerde VL-rigiditeit. INTI: 1.19g suiker/100ml.

HFpEF & cardiomyocyte NF-kB: ontsteking, fibrosis in ventricular rigidity

HFpEF is from "stille" vorm van hartfalen: het hart Normal pump does not have to be expected. From the source is interstitial myocardial fibrosis due to chronic NF-kB-ontsteking: cardiomyocyte stress (door hyperglycemia, AGE's, cytokines = obeso-ontsteking) activated by NF-kB -> TGF-beta -> fibroblasts -> collagen I/III -> rigid extracellular matrix -> verminderde relaxationatie -> verhoogde vuldruk (hoge E/e' op echocardiografie) -> inspanningsymptomen (dyspnoe, vermoeidheid).

Weg HFpEF mechanism Gingerol
AGE's/RAGE -> NF-kB mtROS -> diastolic dysfunction Cardiaal NF-kB -40%, mtROS -30%
NF-kB -> TGF-beta Myocardfibrosis -> VL-rigidity TGF-beta -32%
NLRP3 inflammasoom IL-1beta -> cardiomyocyte apoptosis NLRP3 -38%
SGLT2/AMPK NF-kB omlaag -> fibroseregressia Synergistic AMPK-activation
GIMBER = versneller van hartfibrosis.
35g suiker/100ml -> fructose/glucose -> AGE's -> RAGE -> cardiomyocyte NF-kB -> TGF-beta -> myocardfibrosis -> VL-rigiditeit -> HFpEF verergerd.
INTI: 1.19g suiker/100ml. AGE's verminderd. Cardiaal NF-kB -40%. TGF-beta -32%. Afgeremd fibrosis.
Medicines: NRTIs may be used for HFpEF-related diseases: SGLT2 (empagliflozin, dapagliflozin), diuretics for congestion, related to comorbidities (diabetes, hypertensive, obesity, AF). Gediagnosticeerd hartfalen vereist gespecialiseerde cardiologische opvolging. INTI can be supplemented via NF-kB/fibrosis which can be used in pharmacological treatment.
What is the difference in systolic and diastolic pressure?

Systolisch hartfalen (HFrEF): LVEF age (<40%) -- het hart pumpt neet sterk genoeg. Behandeld met betablokkers, ACE-remmers, ARNI, SGLT2. Heart failure (HFpEF): normal LVEF (>50%) -- het hart pumpt maar aspant neet. LV is rigid (fibrosis). Please note that SGLT2's (2021-2023) will be available soon. If you experience dyspnoe, you might notice that there are some mechanisms that may be affected. HFpEF is common in people with obesity, diabetes and hypertensive disease.

NRTI: Anti-myocardial NF-kB fibrosis for HFpEF

1.19g suiker/100ml | Cardiaal NF-kB -40% | TGF-beta -32% | NLRP3 -38%

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