LAUSR

Key Points Question Are subclinical measures of cardiovascular and noncardiovascular organ function differentially associated with the incidence of heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF)? Findings In this cohort study of 4361 Black US residents, factors associated with incident HFpEF included left atrial diameter, pulse pressure, percent predicted forced expiration volume in 1 second, estimated glomerular filtration rate, and hemoglobin A1c levels, while factors associated with incident HFrEF included left ventricular mass index, left ventricular ejection fraction, percent predicted forced expiration volume in 1 second, and estimated glomerular filtration rate. Measures of cardiovascular function were more strongly associated with incident HFrEF, while measures of noncardiovascular function were more strongly associated with incident HFpEF. Meaning These findings suggest that partially distinct mechanisms may underlie HFrEF and HFpEF, with a greater contribution of multisystem noncardiac impairments to HFpEF.