Abstract： Objective To investigate the distribution of Chinese syndromes in early stage of heart failure with preserved ejection fraction(HFpEF).Methods Clinical data of 300 patients with early stage of HFpEF in Xiyuan Hospital,China Academy of Chinese Medical Sciences were collected,and the patient's gender,age,body mass index,basic disease,left atrial diameter,relative wall thickness,E/A,E/e' were statistically described;The diagnosis criteria for six syndromes in the expert consensus,including qi deficiency,blood stasis,water-fluid retention,yang deficiency,phlegm stasis,and yin defi-ciency,were used to evaluate the patient's Chinese medicine syndromes.Those who did not meet the di-agnostic criteria were determined to have a corresponding syndrome tendency.The distribution and combination of Chinese medicine syndromes of patients,the distribution and combination of Chinese medicine syndrome tendency,and the combination of main Chinese medicine syndromes and tendency were statistically described;Chi-square test was used to compare the changes of cardiac structure and function in patients with different Chinese medicine syndromes.Results(1)The distribution of Chinese medicine syndromes of 300 patients were mainly water-fluid retention pattern and phlegm stasis syndrome;(2)The compound Chinese medicine syndromes was mainly the combination of mainly water-fluid retention and phlegm stasis syndrome;(3)Some patients showed the trend of blood stasis syndrome and qi deficiency syndrome;(4)The frequency of relative wall thickness was higher in patients with water-fluid retention pattern(46.30%,P<0.05),and the frequency of left atrial enlargement was higher in patients with phlegm stasis syndrome(71.10%,P<0.05).Conclusion The core pathogenesis of early stage of HFpEF is disturbance of qihua and water-fluid retention,the distribution of Chinese medicine syndromes is dominated by water-fluid retention pattern and phlegm stasis syndrome,and there is a tendency to show blood stasis and qi deficiency.