Treating heart failure with preserved ejection fraction (HFpEF) is one of the greatest challenges in cardiovascular medicine today. Advances in diagnostic phenotyping of HF led to HFpEF identification. HFpEF is a novel kind of heart failure that results from silent and progressive stiffening of the heart muscle and the inefficiency of pumping blood from the left ventricle. HFpEF is a more chronic HF syndrome that generally develops after years of insults to the heart and non-cardiac organs like the liver, kidney, fat, and muscle. Symptoms of HFpEF include fatigue, shortness of breath, and chest discomfort. However, this disease still often goes undetected due to comorbidity, subtle symptoms, and a lack of awareness in patients.
HFpEF is marked by significant morbidity and mortality, including a 35% 2-year rate of HF hospitalization and 14% 2-year mortality making it the most common form of heart failure (HF). HFpEF is growing in prevalence among women suffering from obesity and diabetes, the symptoms of which are often unnoticed until it is too late. Women experience much more aggravated symptoms of HFpEF, and treatment is also less effective than in men. Moreover, advanced age, metabolic diseases, and hypertension are the dominant complications in women contributing to HFpEF pathogenesis.
A Maritimes-wide Research Project…
Dr. Thomas Pulinilkunnil and his team are investigating the biological, genetic, and molecular origins of this disease. HFpEF constitutes half of all heart failure cases today with notably high incidence rates in New Brunswick women and is noticed in many cases post-menopause. HFpEF is especially prevalent in the Maritimes, claiming the lives of approximately 193 to 200 individuals per 100,000.
Dr. Pulinilkunnil expects that more complex cases of HFpEF are around the corner as obesity and diabetes becomes a growing concern. Metabolic chaos during obesity and diabetes fuels the pathogenesis of HFpEF. Dr. Pulinilkunnil and his team of graduate students, Postdoctoral fellows, staff, and faculty collaborators are examining the molecular mechanisms by which perturbations in nutrient metabolism drive HFpEF pathology in men and women.
The research team continues to grow and now also involves a team of Nova Scotia researchers. Together, they’ve formed the Dalhousie Cardiac Research Excellence Wave (https://medicine.dal.ca/research/cardiovascular-research.html), expanding the scope of the project to be Maritimes-wide.