Supplementary data to this article can be found online at http://dx.doi.org/10.1016/j.ijcha.2015.07.004. ; Existing diagnostic guidelines for heart failure with preserved ejection fraction (. HFPEF) primarily comprise natriuretic peptides and echocardiographic assessment, highlighting the role of diastolic dysfunction. However, recent discoveries of novel plasma markers implicated in pathophysiology of heart failure and technological advances in imaging provide additional biomarkers which are potentially applicable to HFPEF. The evidence base for plasma extra-cellular matrix (ECM) peptides, galectin-3, ST2, GDF-15 and pentraxin-3 is reviewed. Furthermore, the capabilities of novel imaging techniques to assess existing parameters (e.g. left ventricular ejection fraction, systolic & diastolic function, chamber size) and additional derangements of the ECM, myocardial mechanics and ischaemia evaluation are addressed. ; This work has been supported by funding from the National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Unit and Department of Cardiovascular Sciences, University Hospitals of Leicester. ; Peer-reviewed ; Publisher Version