{Reference Type}: Journal Article {Title}: Literature Review: Pathophysiology of Heart Failure with Preserved Ejection Fraction. {Author}: Ahmed F;Kahlon T;Mohamed TMA;Ghafghazi S;Settles D; {Journal}: Curr Probl Cardiol {Volume}: 48 {Issue}: 9 {Year}: 2023 Sep 20 {Factor}: 16.464 {DOI}: 10.1016/j.cpcardiol.2023.101745 {Abstract}: Heart failure with preserved ejection fraction is a growing public health concern, a disease with poor health outcomes, and is showing increased prevalence globally. This review paper explores the literature with a focus on the pathophysiology and microbiology of preserved ejection fraction heart failure while drawing connections between preserved and reduced ejection fraction states. The discussion teases out the cellular level changes that affect the overall dysfunction of the cardiac tissue, including the clinical manifestations, microbiological changes (endothelial cells, fibroblasts, cardiomyocytes, and excitation-contraction coupling), and the burden of structural diastolic dysfunction. The goal of this review is to summarize the pathophysiological disease state of heart failure with preserved ejection fraction to enhance understanding, knowledge, current treatment models of this pathology.