Impaired Myocardial Bioenergetics in HFpEF and the Role of Antioxidants

John B. Hiebert, Qiuhua Shen, Amanda Thimmesch*, Janet Pierce
University of Kansas, School of Nursing, Kansas, USA

© Hiebert et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the University of Kansas, School of Nursing, Mail Stop 4043, 3901 Rainbow Blvd., Kansas City, KS 66160,USA; Tel:(913) 588-4338; Fax: (913) 588-1660; E-mail:


Heart failure with preserved ejection fraction (HFpEF) is a significant cardiovascular condition for more than 50% of patients with heart failure. Currently, there is no effective treatment to decrease morbidity and mortality rates associated with HFpEF because of its pathophysiological heterogeneity. Recent evidence shows that deficiency in myocardial bioenergetics is one of the key pathophysiological factors contributing to diastolic dysfunction in HFpEF. Another known mechanism for HFpEF is an overproduction of free radicals, specifically reactive oxygen species. To reduce free radical formation, antioxidants are often used. This article is a summative review of the recent relevant literature that addresses cardiac bioenergetics, deficiency in myocardial bioenergetics, and increased reactive oxygen species associated with HFpEF and the promising potential use of antioxidants in managing this condition.

Keywords: Adenosine triphosphate, Antioxidants, Bioenergetics, Diastolic heart failure, Free radicals, Heart failure with preserved ejection fraction.