The Role of Epicardial Adiposity in Heart Failure With Preserved Ejection Fraction

Inclusion Criteria: * Participant is willing and able to give informed consent for participation in the study. * Aged ≥18 years old * Diagnosed with HFpEF by an experienced cardiologist or signs and symptoms of heart failure with a HFA-PEFF score ≥5 * Able to understand written English Exclusion Criteria: * LV ejection fraction \<45% * Recovered ejection fraction (previous ejection fraction \<40%) unless reduced ejection fraction was in context of tachycardia induced cardiomyopathy (eg atrial fibrillation/atrial flutter) * Severe primary valvular heart disease * HFpEF due to infiltrative cardiomyopathy (cardiac amyloidosis or sarcoidosis), genetic hypertrophic cardiomyopathy, restrictive cardiomyopathy/pericardial disease or congenital heart disease * Known heritable, idiopathic or drug-induced pulmonary arterial hypertension * Absolute contraindications to cardiac CT or MRI including estimated glomerular filtration rate (eGFR) ≤30ml/min/1.73m2. Patients with MRI-compatible devices are be excluded. * Women who are pregnant