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A Precision Medicine Approach to Evaluating HFpEF


Study will conduct deep phenotyping of heart failure patients and utilize UC Davis Health's EXPLORER Total Body PET Scanner for simultaneous imaging of multiple organs

A multidisciplinary team at UC Davis Health will utilize the EXPLORER Total Body PET Scanner to evaluate patients with heart failure.

(SACRAMENTO) — A multidisciplinary team of physicians from UC Davis Health has been awarded a $1.5 million grant from the National Institutes of Health (NIH) / National Heart, Lung and Blood Institute (NHLBI) to research a common but poorly understood type of heart failure.

The funding will allow researchers to take a precision medicine approach to evaluating heart failure with preserved ejection fraction (HFpEF), which occurs when the lower left chamber of the heart is unable to relax and fill properly during the diastolic phase. The condition causes less blood than normal to be pumped throughout the body and is associated with a five-year mortality of 30-60%.

HFpEF accounts for nearly half of all heart failure cases, adding up to at least three million diagnoses in the United States each year. It is associated with multiple medical conditions including hypertension, diabetes, coronary artery disease, obesity, atrial fibrillation, pulmonary hypertension, and chronic kidney disease. There are currently no effective therapies for HFpEF.

“We are very excited to be selected for this grant to improve the evaluation of patients with heart failure with preserved ejection fraction to gain a deeper understanding of the different causes underlying the diagnosis,” said Martin Cadeiras, cardiologist and medical director of UC Davis Health's Heart Failure, Transplantation and Mechanical Circulatory Support Program.

“The incidence of HFpEF is rising in prevalence with our aging population and the ongoing epidemics of obesity, diabetes, and hypertension,” Cadeiras said. “Moreover, the current therapeutics for HFpEF have shown limited effectiveness, increasing the urgency to understand the mechanistic underpinnings of this heterogenous disease.”

The five-year study will focus on a diverse group of patients from the California Central Valley diagnosed with heart failure. Researchers will conduct deep phenotyping analyses, which includes comprehensive molecular analyses, whole body imaging, text and phrase mining from electronic health records as well as machine learning.

The team will utilize UC Davis Health's EXPLORER Total Body Scanner, which acquires PET imaging of the body from head to toe, all at the same time. It is the first and only Total Body PET scanner approved by the FDA in the United States.

“HFpEF is a multi-organ, systemic syndrome that involves multiple pathophysiologic abnormalities beyond left ventricular diastolic dysfunction,” said Javier E. López, cardiologist and director of the UC Davis Health Cardiac and Vascular Rehabilitation Program.

“The EXPLORER will allow us to not only image the heart, but every other organ in the body at the same time,” López said. “It will be the first time researchers are able to evaluate for the biology that's happening in these patients and provide us with a new understanding of this multi-organ interaction.”

The research will operate under the auspices of UC Davis’s School of MedicineDepartment of Internal MedicineCardiovascular Research Institute (CVRI) and NIH-funded Center for Clinical and Translational Science Center (CTSC).

"The institutional infrastructure in place at UC Davis Health will play a critical role in the success of this research," explained Nipavan Chiamvimonvat, the Roger Tatarian Endowed Professor in Cardiovascular Medicine and co-director of the UC Davis Cardiovascular Research Institute. "Partnering with the CVRI and CTSC will provide us with the necessary infrastructure for the proposed study, collection of samples and repositories that will help us achieve our long-term goal of finding new forms of treatment for these patients."

UC Davis co-investigators include Jason Adams, Kwame Atsina, Imo Ebong, Michael Gibson, Anne Knowlton, David Liem and Padmini Sirish of the Department of Internal Medicine, Nicholas Anderson of the Department of Public Health Sciences, Simon Cherry of the Department of Biomedical Engineering, Ramsey Badawi and Guobao Wang of the Department of Radiology, Bruce Hammock of the Department of Entomology and Leighton Izu of the Department of Pharmacology.