Eligibility

Eligible Ages

Over 18 Years

Eligible Sex

All

Accepts Healthy Volunteers

Yes

Criteria

HFpEF Group Inclusion:

- Patients aged ≥ 30 years old with exertional dyspnea (NYHA II and III) and LVEF ≥50%

- BMI ≥ 30

- New diagnosis of HFpEF based on RHC at baseline (elevated PCWP at rest and/or during
exercise)

HFpEF Group Exclusion:

- Primary cardiomyopathy or pericardial disease or ≥ moderate valvular disease

- Dyspnea due to lung disease or CAD

- Severe anemia, liver, or renal disease

- Active cancer

- Systemic active inflammatory or autoimmune disease (e.g. rheumatoid arthritis, SLE,
etc.)

- Recent hospitalization (< 30 days) or coronary revascularization (< 90 days)

- Patients already taking SGLT2i and/or GLP-1A

- Pregnant or breastfeeding

- Inability to tolerate supine position for the PET/CT or CMR scans.

- Contraindications for safe CMR scanning (e.g., uncontrolled claustrophobia, cochlear
implant, implanted neural stimulator)

- Known gadolinium allergy

- Presence of implantable cardiac pacemaker or defibrillator or mechanical valve.

Cardiac Sarcoid Group Inclusion:

- Ambulatory patients aged ≥ 18 years old

- New referrals to the Sarcoid Clinic with a confirmed but untreated diagnosis of
definite or probable CS based on 2014 HRS consensus (see Table 2)

- With a positive cardiac 18F-FDG PET scan within 30 days.

Cardiac Sarcoid Group Exclusion:

- Already on immunosuppressive therapy

- Pregnant or breastfeeding

- Severe liver or renal disease (estimated GFR < 30 or dialysis-dependent)

- Recent coronary revascularization (< 90 days)

- Active cancer

- Known gadolinium allergy

- Inability to tolerate supine position for the PET/CT or CMR scans.

- Contraindications for safe CMR scanning (e.g., uncontrolled claustrophobia, cochlear
implant, implanted neural stimulator)

- Presence of implantable cardiac pacemaker or defibrillator or mechanical valve.

Healthy Controls Group Inclusion:

- Adults ≥ 30 years old

- No major chronic disease (cardiopulmonary, inflammatory, autoimmune, cancer, renal
or liver impairment, etc.)

- No intake of relevant medication, defined as regular intake of at least one of the
following: anticoagulants, antiplatelets, antihypertensive / diuretics,
antidiabetics, antiarrhythmic, immunosuppressants, chemotherapy,
antibiotics/antivirals/antifungals

Healthy Controls Group Exclusion:

- BMI ≥ 30

- Pregnant or breastfeeding

- Known gadolinium allergy

- Inability to tolerate supine position for the PET/CT or CMR scans.

- Contraindications for safe CMR scanning (e.g., uncontrolled claustrophobia, cochlear
implant, implanted neural stimulator)