Inclusion Criteria |
1. Age 50 years old or older |
2. Left ventricular ejection fraction (EF) ≥ 50% documented by an echocardiogram within 12 months of enrollment |
3. Diagnosis of HFpEF within a 12-month period |
4. Symptoms of dyspnea and New York Heart Association (NYHA) Classification II-or greater symptoms, and a diagnosis of HFpEF defined by ONE of the following: |
4a. Previous hospitalization for HF with radiographic evidence (pulmonary venous hypertension, vascular congestion, interstitial edema, or pleural effusion) of pulmonary congestion |
4b. Invasive hemodynamics |
4c. Echocardiographic evidence of diastolic dysfunction |
4d. Elevated NT-proBNP (> 400 pg/mL) or BNP (> 200 pg/mL) |
4e. No use of intermittent sublingual nitroglycerin within 12 months |
5. Willingness to provide informed consent |
6. Have a telephone or reliable phone contact |
7. Have their own means of transportation to the study site |
Exclusion Criteria |
1. Acute coronary syndrome in the past 12 weeks |
2. Severe valvular heart disease |
3. Severe cardiac fibrosis (galectin-3 level > 26 ng/ml) |
4. Constrictive pericardium |
5. Pulmonary fibrosis |
6. Congenital heart disease |
7. Hypertrophic or infiltrative cardiomyopathy |
8. Heart transplant |
9. Left ventricular assist device |
10. HF associated hospital admission or ED visit within past 30 days |
11. Percutaneous coronary intervention in the last month |
12. Renal (Creatinine > 3) and/or severe hepatic dysfunction |
13. Severe cognitive impairment |
14. No current consumption of any CoQ10 (ubiquinol) or D-ribose supplements |