Clinical Research Directory

Inclusion Criteria: * 1.Aged ≥ 60 years old; * 2.Meeting the diagnostic criteria for HFpEF: 1. Consistent with the epidemiological and demographic characteristics of HFpEF patients; 2. Presence of clinical symptoms and/or signs of heart failure; 3. Cardiac imaging examination indicating LVEF ≥ 50%; 4. In sinus rhythm: BNP ≥ 35 pg/ml and/or NT-proBNP ≥ 125 pg/ml;In atrial fibrillation: BNP ≥ 105 pg/ml and/or NT-proBNP ≥ 365 pg/ml; 5. Meet at least one of the following conditions: 1. LVMI ≥ 115 g/m² (male) or ≥ 95 g/m² (female); 2. LAVI \> 34 ml/m²; 3. Relative wall thickness \> 0.42, or left ventricular free wall thickness \> 12 mm; 4. Septal e' \< 7 cm/s, or lateral e' \< 10 cm/s, or average E/e' ≥ 14; 5. Tricuspid regurgitation velocity \> 2.8 m/s, or pulmonary artery systolic pressure \> 35 mmHg; * 3.NYHA functional class Ⅱ-Ⅲ; * 4.Complicated with metabolic diseases such as hypertension, diabetes and obesity; * 5.Accompanied by gastrointestinal symptoms; * 6.Well-tolerated to current anti-heart failure regimens with stable medication for at least 1 month; * 7.Stable heart failure condition without acute exacerbation; * 8.Basically normal cognitive function, capable of understanding scale assessment contents; * 9.Able to perform daily activities independently; * 10.Fully understanding the purpose of this clinical trial, voluntary participation and signing of written informed consent. Exclusion Criteria: * 1.Symptoms caused by non-cardiac diseases; * 2.Patients with any contraindication to Fecal Microbiota Transplantation (FMT): 1. Patients with severe intestinal barrier damage induced by various causes, such as sepsis, active massive gastrointestinal bleeding, intestinal perforation; 2. Patients diagnosed with fulminant colitis or toxic megacolon; 3. Patients unable to tolerate enteral nutrition meeting 50% of calorie requirements due to severe diarrhea, significant fibrous intestinal stenosis, severe gastrointestinal hemorrhage, high-output intestinal fistula and other conditions; 4. Patients with congenital or acquired immunodeficiency diseases; 5. Patients receiving high-risk immunosuppressive or cytotoxic drugs recently, such as rituximab, doxorubicin, or moderate-to-high dose steroids (prednisone ≥ 20 mg/d) administered continuously for more than 4 weeks; 6. Severely immunosuppressed patients with neutrophil count \< 1500/mm³; * 3.History of myocardial infarction, coronary artery bypass grafting, or any event that may reduce LVEF within 6 months before enrollment (unless LVEF ≥ 50% was confirmed); * 4.Received valve replacement surgery within 6 months before enrollment; * 5.Poorly controlled blood pressure (SBP ≥ 180 mmHg or DBP ≥ 100 mmHg); * 6.Current acute decompensated heart failure requiring intervention; * 7.Resting heart rate \> 120 beats per minute, or complicated with malignant arrhythmia; * 8.Significant coronary artery disease requiring PCI revascularization; * 9.Severe renal insufficiency (serum creatinine \> 442 μmol/L) or patients on dialysis; * 10.Pre-existing gastrointestinal diseases, including ulcerative colitis, Crohn's disease, irritable bowel syndrome, chronic diarrhea; * 11.Current malignant tumors requiring anti-tumor treatment; * 12.Complicated with acute diseases or acute exacerbation of chronic diseases at present; * 13.Participation in other interventional clinical trials or oral intake of probiotic preparations within the past 3 months.