UTA scientists part of NIH-funded study of precision therapy for HFpEF patients

Nearly half of all heart failure patients do not have effective treatments for their condition, so three researchers at The University of Texas at Arlington are taking a more precise approach.

Mark Haykowksy, Michael Nelson and Paul Fadel, faculty members in the College of Nursing and Health Innovation, are part of an $11 million project funded by the National Institutes of Health to study the mechanisms of exercise intolerance in heart failure patients with preserved ejection fraction, or HFpEF, a condition in which the heart pumps normally but is too stiff to fill properly.

UTA's share of the NIH-funded project, which is being conducted in collaboration with UT Southwestern Medical Center, is $3.5 million.

The major strength of this new grant is that it brings together multiple investigators from UTA and UT Southwestern to tackle an important health problem. HFpEF patients have reduced quality of life and lowered tolerance for the activities of daily living. We are taking a whole-body, interdisciplinary approach to work as a team and address this problem head-on."

Michael Nelson, associate professor of kinesiology, University of Texas at Arlington

HFpEF is the fastest-growing type of heart failure and is found mostly in older individuals. The mortality rate for these patients is high, and the cardinal feature among them is impaired exercise tolerance.

While evidence-based drug therapies improve survival in heart failure patients with reduced ejection fraction, they do not improve survival in those with preserved ejection fraction, said Haykowsky, professor of nursing and the Mortiz Chair of Gerontological Nursing Research.

"HFpEF affects each patient differently," Haykowsky said. "In this project, we'll phenotype patients based on their pathophysiology of exercise intolerance and empower the development of personalized strategies to improve overall health-related fitness."

Researchers at UTA and UTSW will focus on identifying common characteristics among HFpEF patients based on cardiac, pulmonary and skeletal muscle limitations that impede their ability to exercise in order to determine the best therapies for those groups.

"We are working to uncover effective therapeutic targets to improve quality of life and reduce the excessive morbidity and mortality present in this patient group," said Fadel, professor of kinesiology and CONHI's associate dean for research.

Emerging data suggests that the prevalence of HFpEF continues to increase, likely because of the increased incidence of common risk factors, such as older age, hypertension, metabolic syndrome, renal dysfunction and obesity.

Fadel is studying the role of the autonomic nervous system and Haykowsky the role of peripheral oxygen delivery and utilization by the muscles. Nelson will utilize novel magnetic resonance imaging techniques to assess specific cardiac, skeletal muscle and pulmonary mechanisms contributing to exercise intolerance in patients with HFpEF.

"I am proud to see Drs. Haykowksy, Nelson and Fadel play integral roles in a world-class team of researchers taking a unique approach to a very important health issue," said Elizabeth Merwin, dean of CONHI. "They are representing the commitment of researchers at UTA to consider health issues from a broader perspective to improve the quality of life of our patients."

"The sum is greater than the individual parts," Nelson said. "This collaboration would not be possible had it not been for the vision and support of President Vistasp Karbhari and research leadership to attract Mark, Paul and myself to UTA just a few years ago. We are honored to be a part of the strong integrative physiology scientific community in the Dallas-Fort Worth Metroplex."