In a compelling blend of scientific collaboration and athletic determination, University of Vermont researchers Matthew Caporizzo, Ph.D., assistant professor of molecular physiology and biophysics at the Robert Larner, M.D. College of Medicine, and Nicole Habel, M.D., Ph.D., assistant professor of medicine at Larner and cardiac electrophysiologist at the University of Vermont Medical Center, will step out of the lab and onto the racecourse at this year’s Vermont City Marathon on May 24. Their goal is simple but urgent: elevate public awareness of a heart condition affecting more than 3 million Americans that is responsible for roughly half of all heart failure cases.
Heart failure with preserved ejection fraction (HFpEF), formerly known as diastolic heart failure, is a condition where the heart’s main pumping chamber pumps normally but becomes too stiff to relax and fill with adequate blood between beats. This causes a person to feel unusually fatigued, short of breath, and unable to sustain physical activity—but not necessarily aware their heart is failing. More often, people attribute these symptoms to normal aging and believe they should stop exercising, when the opposite is true.
“When the real issue is the heart’s impaired ability to relax, it is better for the person to stay physically active rather than slow down.” — Nicole Habel, M.D., Ph.D.
“It’s unfortunate when patients believe they ‘have to’ slow down.’ When the real issue is the heart’s impaired ability to relax, it is better for the person to stay physically active rather than slow down,” says Dr. Habel. “Our goal is to encourage people to stay physically active and get a proper diagnosis if they feel unusually tired and out of breath.”
To amplify their message, Drs. Habel and Caporizzo will run Sunday’s marathon wearing custom-made race shirts emblazoned with their team name—“Tachy Pacers,” a nod to faster heart rates in HFpEF, encouraging fellow runners and spectators to learn more. Habel’s shirt number will also match her individualized heart rate in the case of HFpEF: 78 beats per minute.
Findings from two clinical studies, the myPACE trial and the PACE HFpEF trial, show that the heart may be far more adaptable than once believed. By using a treatment called accelerated pacing, where the patient’s heart rate is slightly elevated with a pacemaker, researchers have demonstrated that it is possible not only to improve symptoms like shortness of breath and fatigue, but also to encourage the heart to “reshape” itself in healthier ways, a concept known as cardiac plasticity.
That’s where Caporizzo’s lab steps in. Using advanced technology capable of simulating whole-heart behavior from tiny cardiac samples, his team is working to uncover the molecular mechanisms behind these clinical improvements. “We can’t dissect a patient’s heart, of course, but we can recreate its function in the lab,” Caporizzo says. “This lets us understand who benefits most from pacing and how to optimize therapy over time.”
Together, Habel and Caporizzo’s work aims to pave the way for more targeted treatments that address the root causes of stiff heart muscle failure.
This collaborative partnership represents a model for modern translational research: a clinician–scientist team bridging the gap between patient care and molecular discovery. This benchtop-to-bedside approach is increasingly recognized as essential for developing next-generation therapies.
With limited treatment options available, Caporizzo and Habel are using their personal marathon efforts to spotlight the critical need for improved therapies and earlier recognition of the condition. Running the marathon is more than a symbolic gesture, however. It is a public demonstration of the message shared with patients every day: Physical activity is essential to healthy aging, and maintaining movement, even in small ways, can be transformative.
“Teaming up to take care of ourselves is about leading by example and investing in our future” says Caporizzo. “The key to healthy aging isn’t running one marathon. It’s building a habit of staying physically active.”
Momentum from the PACE HFpEF trial has sparked major national and international interest. Two large multicenter studies are now under way (Fast Induced Remodeling in Heart Failure With Preserved Ejection Fraction, a clinical trial at 10 U.S. sites; and the Randomized Trial of ELEVATEd Cardiac Pacing Rate for Personalized Treatment of Heart Failure With Preserved Ejection Fraction trial at 50 global sites), with the University of Vermont serving as a lead investigative center for both.
“The key to healthy aging isn’t running one marathon. It’s building a habit of staying physically active.” — Matthew Caporizzo, Ph.D.
The team is now preparing to launch a new clinical investigation that will examine tiny tissue samples from patients receiving accelerated pacing therapy. Seed grants from the Vermont Center for Cardiovascular and Brain Health and the Vermont Cardiovascular Research Institute are supporting the preliminary work to get larger NIH funding required to fully sustain the effort. By studying these samples at the cellular level, researchers aim to uncover how pacing triggers beneficial remodeling in the heart. This deeper understanding will guide the development of more targeted HFpEF treatments and help clinicians identify which patients are most likely to benefit from accelerated pacing.
Research like this has contributed to the University of Vermont’s designation by the Carnegie Classification of Institutions of Higher Education as an R1 institution, placing it in the top tier of research universities in the U.S.
