This proposed study aim to:

1. Determine intra-LV pressure-time profile non-invasively using recently developed echo Doppler VFM analysis and applanation tonometry and myocardial elastic properties, in HF subjects (both HFNEF and HFREF) compared to normal volunteers.
2. Correlate calculated intra-LV pressure parameters with NT ProBNP levels.

Heart failure (HF) is a common disease and its syndrome is difficult to diagnose. HF with reduced ejection fraction (HFREF) may be diagnosed based on impaired LVEF (<50%). However, diagnosis of HF with normal ejection fraction (HFNEF) is mainly based on the presence of signs and symptoms.

Central to diagnosis of HF is estimation of intra-cardiac pressure, which can only be obtained from invasive catheterization.

This proposed study aim to:

1. Determine intra-LV pressure-time profile non-invasively using recently developed echo Doppler VFM analysis and applanation tonometry and myocardial elastic properties, in HF subjects (both HFNEF and HFREF) compared to normal volunteers.
2. Correlate calculated intra-LV pressure parameters with NT ProBNP levels.

Inclusion Criteria:

• Either

  1. has presented to hospital with a primary diagnosis of Heart Failure or

  2. is attending a hospital clinic for management of Heart Failure within 6 months of an episode of decompensated heart failure, which either:

     • resulted in a hospital admission (primary diagnosis) or
     • was treated in out-patient clinic

• LVEF >50% is used as cut-off value for HFNEF and LVEF < 50% for HFREF.

• NT-proBNP within 7 days of admission > 220pg/ml. If there is no result available, NT-proBNP on the same day as echo scan must be > 220pg/ml.

Exclusion Criteria:

• Haemodynamically significant valve disease defined as more than mild degree of valve stenosis, or more than moderate degrees of mitral or aortic valve regurgitation.
• History of valvular disease, i.e. rheumatic heart disease and/or having undergone valvular replacement.
• Isolated right heart failure due to pulmonary disease.
• Presence of haemodynamically significant obstructive lesions of left ventricular outflow tract.
• History of any organ transplant or who was on a transplant list (life expectancy < 6 months at time of enrollment).
• Presence of end-stage renal failure.
• Pregnancy.
• The patient is unable to provide written informed consent.

35 diagnosed heart failure patient will be recruited from primary care clinic, outpatient clinics and hospital ward from NHCS.

40 Healthy Volunteer control group.