3 Million Americans Have Hard-To-Spot Heart Failure. Risk Marker Stands Out

Approximately 3 million Americans grapple with a form of heart failure that's difficult to detect early and challenging to treat—known as heart failure with preserved ejection fraction (HFpEF). This condition arises when the heart's left ventricle wall stiffens and thickens, hindering its ability to pump sufficient blood for daily activities.

HFpEF disproportionately affects women and is on the rise. More than 80% of those diagnosed also suffer from pulmonary hypertension (PH), a dangerous combination often referred to as PH-HFpEF. Despite numerous clinical trials targeting treatment, few effective options exist.

The study, conducted by researchers at the University of Wisconsin-Madison and the Morgridge Institute for Research, aims to better identify which patients face the greatest risk. Lead author Farhan Raza, a cardiologist, likened navigating the condition to traversing the ocean without a map. The researchers performed detailed cardiac tests on 48 PH-HFpEF patients, finding that those with dysfunctional right ventricles—responsible for pumping blood to the lungs—experienced significantly higher mortality and hospitalization rates.

Right ventricle function emerged as a stronger predictor of patient outcomes than previously used measures.

Investigating potential contributors to the disease, the researchers discovered weakened mitochondria, the cellular energy-producing structures, and heightened activity in RNA metabolism, a mechanism aiding protein production. They identified several genes expressed differently in those with right ventricle dysfunction, including GATD3, which could potentially serve as targets for future treatments.

While acknowledging the study's limitations—comprising only 48 patients—a cardiologist and chief medical officer emphasized that PH-HFpEF should be viewed as a disease affecting the entire cardiopulmonary system, not just the left ventricle.