Erik Fung, MBChB, PhD, FACC; Susanna S. S. Ng, MBChB, MRCP, FHKAM; Gloria H. W. Lau, MSc, CPT; Leong Ting Lui, PhD.
Competition Sponsor: The Chinese University of Hong Kong and The University of Hong Kong
Heart failure (HF) is predominantly an aging-related disorder that affects at least 1-2% of the general population. As a leading cause of hospital readmission, it will increase in numbers with global aging. First diagnosis of HF often occurs as life-threatening cardiorespiratory distress, although patients may have had weeks to years of functional decline and symptoms, including easy fatigability, shortness of breath, leg swelling and chest discomfort. In the natural biology of aging, cardiac muscles stiffen as ventricular relaxation and filling are impaired (i.e. diastolic dysfunction (DD)). Biochemical changes in the heart and vessels are detectable in the blood circulation and in exhaled breath that precede cardiac imaging findings. Past studies have demonstrated early metabolic shifts in the heart from utilization of fatty acids to ketones and pentanes. These and other volatile organic compounds (VOCs) may be detectable in preclinical HF but have not been explored. Early detection of HF remains difficult, as it requires detailed history-taking, physical examination and investigations. However, a biochemical window of opportunity to catch aging-related preclinical HF with primarily DD (i.e. HF with preserved ejection fraction or HFpEF) could have a profound impact on early detection. This proof-of-concept study draws on recallable study participants from two longitudinal cohorts including over 1,200 older adults with cardiac imaging, biomarker and other high-dimensional datasets, and will aid in the discovery of VOCs that could indicate preclinical HFpEF. Upon validation, these efforts could lead to the development of a cost-effective biomarker panel for screening at-risk older adults in the community.