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Blood Signature of Pre-Heart Failure: A Microarrays Study 1 1 1,2 1 1 Fatima Smih *, Franck Desmoulin , Matthieu Berry , Annie Turkieh , Romain Harmancey , Jason 1 1,2 1,2 1,2 1,2 1 Iacovoni , Charlotte Trouillet , Clement Delmas , Atul Pathak , Olivier Lairez , Franc¸ois Koukoui , 1,2 2 1,2 1,2 Pierre Massabuau , Jean Ferrieres , Michel Galinier , Philippe Rouet ´ 1 INSERM/Universite Paul Sabatier UMR 1048, Institut des Maladies Metaboliques et Cardiovasculaires (I2MC), Toulouse, France, 2 Rangueil Hospital University, Cardiology Department, Toulouse, France Abstract Background: The preclinical stage of systolic heart failure (HF), known as asymptomatic left ventricular dysfunction (ALVD), is diagnosed only by echocardiography, frequent in the general population and leads to a high risk of developing severe HF. Large scale screening for ALVD is a difficult task and represents a major unmet clinical challenge that requires the determination of ALVD biomarkers. Methodology/Principal Findings: 294 individuals were screened by echocardiography. We identified 9 ALVD cases out of 128 subjects with cardiovascular risk factors. White blood cell gene expression profiling was performed using pangenomic microarrays. Data were analyzed using principal component analysis (PCA) and Significant Analysis of Microarrays (SAM). T