“…Left atrial enlargement and dysfunction, including reduced left atrial systolic reserve, can eventually lead to the development of HFpEF (Nagai et al, 2023;Li et al, 2024). Secondly, in patients with chronic systemic inflammation such as hyperemia, systemic secreted inflammatory cytokines can cause the accumulation and inflammatory response of epicardial adipose tissue, which can promote the migration and transformation of mesenchymal stem cells and local secretion of inflammatory cytokines, leading to deep myocardial cell inflammation, increased myocardial stiffness, deep myocardial fibrosis, and finally HFpEF (Obokata et al, 2017;Gevaert et al, 2022;Gao et al, 2023;Rossi et al, 2023). In addition, microcirculation disorders also play an important role in the occurrence and development of HFpEF (Camici et al, 2020).…”