External Body Pressure in Heart Failure With Preserved Ejection Fraction

Heart Failure Study Population Inclusion Criteria (Aim 1 and 2): Age greater than or equal to 30 yrs Established diagnosis of HFpEF with left ventricular ejection fraction greater than or equal to 50% NYHA II-III symptoms Stable HF drug regimen for the preceding 1 month Wedge pressure greater than or equal to 15 mmHg at rest or greater than or equal to 25 mmHg with peak exercise (For Aim 2 only) Scheduled for an elective right heart catheterization at Duke University Hospital. Exclusion Criteria (Aim 1 and 2): HF hospitalization for type I myocardial infarction within 3 months Infiltrative (ie amyloid) or hypertrophic cardiomyopathy Uncontrolled atrial or ventricular arrhythmia Chronic oxygen use History of vasovagal syncope Considered inappropriate to participate by PI or Sub-I Healthy Volunteers (Controls) Inclusion Criteria (Aim 1): Age greater than or equal to 30 yrs Able to speak English Ambulatory [assistive devices ok] Able to provide informed consent Exclusion Criteria (Aim 1): Acute myocardial infarction (3-5 days) Unstable angina Uncontrolled arrhythmia causing symptoms or haemodynamic compromise Syncope Active endocarditis Acute myocarditis or pericarditis Symptomatic severe aortic aneurysm Uncontrolled asthma Arterial desaturation at rest on room air <85% Untreated left main stem coronary stenosis Asymptomatic severe aortic stenosis Severe untreated arterial hypertension at rest (>200 mm Hg systolic, >120 mm Hg diastolic) Tachyarrhythmias or bradyarrhythmias Hypertrophic cardiomyopathy Significant pulmonary hypertension Thrombosis of the lower extremity until treated for a minimum of 2 weeks Within 2 weeks of acute symptomatic pulmonary embolus Abdominal aortic aneurysm >8.0 cm Electrolyte abnormalities Pregnancy Inmate of correctional facility (i.e. prisoner) Diagnosed history of dementia Inability to ambulate independently Considered inappropriate to participate by Principal Investigator