Disclosed herein are compositions and methods for targeted metabolomics profiling to provide absolute quantification of a broad array of metabolic intermediates of fatty acids, amino acids, and carbohydrate metabolism for HFpEF. In an aspect, the disclosure relates to a method for assessing risk of death or a major adverse cardiac event (MACE) in a subject diagnosed with heart failure with preserved ejection fraction (HFpEF). The method may include (a) determining in a sample from the subject the level of each metabolite in at least one factor, wherein the factor is selected from the group consisting of factor 1, factor 3, factor 4, factor 5, factor 10, factor 12, and factor 14； and (b) comparing the level of each metabolite in the sample to a standard, wherein the level of the metabolite in the subject relative to a standard is indicative of the risk of death or MACE in the subject.
