Heart failure with preserved ejection fraction (HFpEF) constitutes approximately half of all patients with
heart failure and causes mortality similar to heart failure with reduced ejection fraction [1]. HFpEF is
highly relevant as novel evidence-based therapies emerge but treatment options remain limited [1].
Diastolic dysfunction is a hallmark of HFpEF and is also very common in up to 80% of high-risk
cardiovascular patients undergoing cardiac surgery [2]. Even without overt HFpEF, echocardiographic
diastolic dysfunction is independently associated with increased mortality [3]. Another important
characteristic of HFpEF is the frequent presence of comorbidities, with one of the most important being
sleep disordered breathing (SDB). SDB affects over one billion patients in the general population and is
highly prevalent in cardiovascular high-risk patients, which underscores its high socioeconomic relevance [4].
Interestingly, SDB patients frequently exhibit diastolic dysfunction [5]; however, the underlying mechanisms
remain elusive thus far [6]. In this cross-sectional experimental study, we analysed the role of inflammation
and fibrosis for diastolic dysfunction in cardiovascular high-risk patients stratified by the prevalence of SDB,
which may provide a groundwork for future therapeutic strategies.