“Phenotyping Heart Failure with Preserved Ejection Fraction Using Non- Invasive Biomarkers

保留射血分数（HFpEF）心力衰竭非常普遍，并与功能耐受性受损、生活质量、发病率和死亡率相关。虽然医学的进步已经导致了有效的治疗心力衰竭和降低射血分数，但治疗HFpEF的治疗方案非常有限。虽然目前的临床评估提供了一些除射血分数以外的信息来评估HFpEF患者的心功能，但仍需要确定与心功能受损病理生理机制相关的生物标志物。因此，我们建议通过识别与HFpEF患者运动耐量和生活质量相关的病理生理机制的成像和循环生物标志物来解决这一知识缺口。我们的

Heart failure with preserved ejection fraction (HFpEF) is highly prevalent and associated with impaired functional tolerance, quality of life, morbidity and mortality. Although medical advances have led to effective treatments for heart failure with reduced ejection fraction, there are very limited treatment options for treating HFpEF. While contemporary clinical assessment provides some information beyond ejection fraction in assessment of cardiac function in patients with HFpEF, there is a need to identify biomarkers that associate with pathophysiologic mechanisms of impaired cardiac function. Therefore, we propose to address this knowledge gap by identifying imaging and circulating biomarkers with pathophysiological mechanisms that are associated with exercise tolerance and quality of life in patients with HFpEF. Our specific aim is two-fold: 1) to examine the association of imaging biomarkers of myocardial fiber orientation with exercise tolerance and quality of life and circulating biomarkers in patients with HFpEF, and 2) to examine the association of imaging biomarkers of myocardial energetics with exercise tolerance and quality of life and circulating biomarkers in patients with HFpEF. We will analyze myocardial fiber orientation using a novel diffusion tensor imaging technique in cardiac MRI and myocardial energetics using 31-P magnetic resonance spectroscopy.