This study will include volunteers diagnosed with a form of heart failure that is characterized by a weakened heart muscle that appears to be pumping in a normal manner. This condition is called "heart failure with preserved ejection fraction" or HFpEF. For these individuals, it has been determined that the health problems and symptoms experienced may be due to a significant increase in the pressure of one of the chambers of the heart. This pressure build-up causes a variety of symptoms, including tiredness, difficulty breathing, and reduced ability to exercise/walk.

This study is to help evaluate a new device (the "Satera Ablation System") designed to reduce the build-up of pressure described above. The Satera Ablation system is a catheter used to ablate or destroy the splanchnic nerve on one side of the body. The Sponsor believes by destroying this nerve there may be some reduction in the symptoms caused by HFpEF. The procedure using the Satera Ablation System will be performed in the catheterization lab and does not involve surgery. Participants will stay overnight in the hospital following the procedure for observation.

The length of subject participation in the study will be approximately 24 months and includes 5 office visits, 1 phone call and 2 procedures. Participants in this research study will be randomized to either the treatment group or the control group and have a 2:1 chance of receiving the research treatment with the Satera Ablation System at the time of randomization.

This study will help us learn more about how safe and effective the Satera Ablation System is in treating the symptoms of patients with HFpEF.

This study is enrolling subjects with heart failure and a preserved fraction meaning the heart is too stiff to fill properly to meet the body's needs. This study is researching an investigational device (study device) called the Alleviant ALV1 System. Investigational means it has not been approved for commercial use by the Food and Drug Administration. (FDA) This study will test the safety and effectiveness of the Alleviant ALV1 System. The Alleviant ALV1 System is intended to create a shunt (an opening) in the heart to allow for proper blood flow through the heart which may improve your symptoms. No device is left in your heart it is just used to create the shunt. This is a randomized study which means subjects are assigned by chance to either have the study device create this shunt or not have the study device create the shunt. Randomization is 50/50 meaning there is a 50% chance to have the study device create a shunt and a 50% chance the study device will not be used. Using the study device to create the shunt is performed during a right heart catheterization (RHC) so all subjects will undergo the RHC but only 50% will have the shunt. Neither the subjects nor the study doctor will know which group subjects are randomized to but other study staff will know in the event this information is needed. All subjects will stay overnight in the hospital after the procedure. Other study related procedures include echocardiograms - ultrasound test of the heart, electrocardiograms (ECG) - a tracing of the heart's electrical activity, blood work, questionnaires, 6 minute hall walk test, and assessments of heart failure status. Risks include risks related to the study device including blood vessel damage from placing the device in the vein to get to the heart, risks from the right heart catheterization such as bleeding or bruising, abnormal heart beats, and risks related to study related procedures. There may be risks that are not known at this time. Participation in this study is expected to last about 60 months and include approximately 15 in person visits and 3 telephone calls.

The PRE-EMPT study is designed to identify people who may have early signs of heart disease even though they are considered to be at low risk for heart problems. Participants will undergo specialized heart scans to look for plaque buildup in the arteries that supply blood to the heart. Individuals found to have early plaque may be invited to participate in a treatment phase of the study. In this phase, participants will receive either study medications (rosuvastatin and/or colchicine) or placebo tablets and will also receive support for healthy lifestyle behaviors through a digital health platform. Patients will be randomized to one for four treatment groups. Researchers will follow participants for approximately two years to determine whether these treatments and lifestyle interventions can slow or reduce plaque buildup in the heart arteries. Information gained from this study may help improve strategies for detecting and treating early heart disease in the future.