Endothelial-to-mesenchymal transition and microRNA-21: the game is on again.

In the presence of any left ventricular dysfunction, be it systolic or diastolic, there is an increased risk of developing heart failure (HF). Survival expectancy has been improved in HF patients with reduced systolic function, but not for those with a normal ejection fraction.1,2 Moderate or severe diastolic dysfunction, which is predictive of all-cause death, has a prevalence of 7% in asymptomatic individuals and 75% among symptomatic HF patients.3 Regardless of its high prevalence, diastolic HF has received less attention than the systolic type.2