Vascular Dysfunction in Heart Failure: From Macro to Microcirculation

Heart failure remains one of the leading causes of morbidity and mortality worldwide, affecting millions of patients across both preserved and reduced ejection fraction phenotypes. While much of the research focus has historically centred on the myocardium, growing evidence points to vascular dysfunction as a central driver of disease onset, progression, and clinical outcomes. Impairments at every level of the vascular tree, from large conduit arteries to the coronary and systemic microcirculation, contribute to the haemodynamic, metabolic, and inflammatory disturbances that characterise heart failure.Despite this, the macro and micro vascular compartments are often studied in isolation. A more integrated view is needed to understand how these interconnected systems shape disease phenotype, response to therapy, and long term prognosis. Recent advances in imaging, invasive and non invasive functional assessment, and molecular profiling now allow researchers to bridge this gap and explore vascular dysfunction as a continuum rather than a set of separate phenomena.This Research Topic aims to bring together the latest mechanistic, translational, and clinical research on vascular dysfunction in heart failure, spanning both HFpEF and HFrEF. We welcome contributions that explore the interplay between large vessel stiffness, endothelial function, coronary microvascular dysfunction, and systemic microcirculatory impairment, as well as their links to cardiac remodelling, exercise intolerance, and patient outcomes.We invite Original Research, Reviews, Mini Reviews, Perspectives, and Methods articles addressing themes including, but not limited to:• Mechanisms linking macro and microvascular dysfunction in heart failure;• Coronary microvascular dysfunction in HFpEF and HFrEF;• Endothelial dysfunction, arterial stiffness, and ventricular vascular coupling;• Systemic and peripheral microcirculatory changes and their role in symptoms and prognosis;• Novel imaging and functional techniques to assess vascular dysfunction across scales;• Sex, age, and comorbidity related differences in vascular involvement;• Pharmacological and device based therapies targeting the vascular compartment;• Biomarkers and multi omics approaches to characterise vascular phenotypes in heart failure.By bringing macro and microvascular research into a single forum, this collection seeks to advance our understanding of heart failure as a systemic vascular disease and to inform future diagnostic and therapeutic strategies. Topic editors: Yuji Nagatomo, Jun Feng, Nobuyuki Masaki Source: https://www.frontiersin.org/research-topics/83989/vascular-dysfunction-in-heart-failure-from-macro-to-microcirculation