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Phenomapping in heart failure with preserved ejection fraction: insights, limitations, and future directions

CARDIOVASCULAR RESEARCH (2023)

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Aetiological classification and prognosis in patients with heart failure with preserved ejection fraction

Antoine Fayol et al.

Summary: This study classified HFpEF patients into secondary and idiopathic groups based on etiology, revealing differences in prognosis and mortality rates between the two groups. Unsupervised clustering analysis identified three phenogroups, with the one having the highest proportion of idiopathic HFpEF showing a better prognosis and higher prevalence of non-cardiac co-morbidities such as chronic obstructive pulmonary disease and obesity compared to the groups enriched with secondary HFpEF.

ESC HEART FAILURE (2022)

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Article Cardiac & Cardiovascular Systems

2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure

Paul A. Heidenreich et al.

Summary: The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure provides patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with heart failure. It is based on contemporary evidence and aims to improve quality of care and align with patients' interests.

JOURNAL OF CARDIAC FAILURE (2022)

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Article Medicine, General & Internal

Comorbidities and their implications in patients with and without type 2 diabetes mellitus and heart failure with preserved ejection fraction. Findings from the rica registry

Jose Carlos Arevalo-Lorido et al.

Summary: Analyzing comorbidity clusters among patients with HFpEF revealed that those with T2DM had a greater disease burden and worse prognosis, especially in cluster 3 which showed the poorest outcomes.

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE (2021)

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Article Cardiac & Cardiovascular Systems

The effects of liraglutide and dapagliflozin on cardiac function and structure in a multi-hit mouse model of heart failure with preserved ejection fraction

Coenraad Withaar et al.

Summary: The study developed a mouse model that resembles the human HFpEF disease and suggests that attenuation of cardiometabolic dysregulation may be a novel therapeutic target for the treatment of HFpEF.

CARDIOVASCULAR RESEARCH (2021)

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Article Cardiac & Cardiovascular Systems

Characteristics, prognosis and treatment response in distinct phenogroups of heart failure with preserved ejection fraction

Jun Gu et al.

Summary: HFpEF patients were classified into three phenogroups using machine learning, revealing significant differences in clinical features, outcomes and treatment response. Beta-blockers or ACEI/ARB therapy was associated with a lower risk of adverse events in specific phenogroup.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Phenotypic clustering of heart failure with preserved ejection fraction reveals different rates of hospitalization

Adrianne Casebeer et al.

Summary: This study characterized subgroups of patients with newly identified HFpEF using unsupervised machine learning, identifying three distinguishable patient clusters representing different phenotypes. The study also evaluated 1-year heart failure related hospitalization rates, suggesting that patient subtypes may respond differently to treatments or interventions.

JOURNAL OF CARDIOVASCULAR MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Myocardial Gene Expression Signatures in Human Heart Failure With Preserved Ejection Fraction

Virginia S. Hahn et al.

Summary: The study revealed distinctive transcriptomic signatures and molecular subgroupings in patients with HFpEF, with specific clinical features and outcomes. Obesity was found to be a major contributor to the upregulation of genes in HFpEF, while pathways related to endoplasmic reticulum stress, autophagy, and angiogenesis were identified as downregulated genes specific to HFpEF.

CIRCULATION (2021)

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Article Cardiac & Cardiovascular Systems

Sacubitril/valsartan for the management of heart failure: A perspective viewpoint on current evidence

Massimo Volpe et al.

Summary: Current international guidelines recommend switching ACE-i or ARBs to sacubitril/valsartan (S/V) in stable outpatients affected by heart failure with reduced ejection fraction (HFrEF) who remain symptomatic despite being on optimal medical therapy. New data may support further clinical applications and benefits of S/V beyond ambulatory HFrEF patients, possibly also in HFmrEF patients. Additional clinical trial data are required to confirm the potential benefits of S/V in patients with mid-range or preserved EF, or in combination with sodium-glucose co-transporter 2 inhibitors or in post-myocardial infarction HF.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2021)

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Editorial Material Cardiac & Cardiovascular Systems

The diverging role of epicardial adipose tissue in heart failure with reduced and preserved ejection fraction: not all fat is created equal

Jasper Tromp et al.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

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Article Cardiac & Cardiovascular Systems

Machine learning based on biomarker profiles identifies distinct subgroups of heart failure with preserved ejection fraction

Rebecca J. Woolley et al.

Summary: This study identified four distinct subgroups of patients with HFpEF based on biomarker profiles, each with unique clinical characteristics and outcomes, indicating different underlying pathophysiological pathways.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

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Article Cardiac & Cardiovascular Systems

From Systemic Inflammation to Myocardial Fibrosis The Heart Failure With Preserved Ejection Fraction Paradigm Revisited

Walter J. Paulus et al.

Summary: According to the comorbidity-inflammation paradigm, comorbidities, especially metabolic ones, are believed to drive the development and severity of heart failure with preserved ejection fraction. Recent evidence includes myocardial infiltration, inducible nitric oxide synthase expression, patient phenogroups, and direct connections between comorbidities, inflammatory biomarkers, and abnormal myocardial structure/function.

CIRCULATION RESEARCH (2021)

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Letter Cardiac & Cardiovascular Systems

Epicardial fat in heart failure with reduced versus preserved ejection fraction

Jasper Tromp et al.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

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Article Cardiac & Cardiovascular Systems

Identification of distinct phenotypic clusters in heart failure with preserved ejection fraction

Alicia Uijl et al.

Summary: This study identified five distinct clusters of HFpEF patients with different clinical characteristics, heart failure drug therapy, and prognosis, confirming the heterogeneity of HFpEF and providing a basis for tailoring drug therapy to individualized in HFpEF patients. Patients in cluster 1 had the best prognosis, while patients in clusters 3 and 5 had the worst age- and sex-adjusted prognosis.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Classifying Heart Failure in the 21st Century Matching Taxonomy With Science

Barry Greenberg et al.

JACC-HEART FAILURE (2021)

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Article Cardiac & Cardiovascular Systems

A new approach to the clinical subclassification of heart failure with preserved ejection fraction

Hirmand Nouraei et al.

Summary: This study identified six distinct clinical subsets within HFpEF patients, each with different long-term outcomes. These subsets include individuals with various comorbidities and risk factors such as hypertension, diabetes, atrial fibrillation, and cardiovascular diseases.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes

Andreas B. Gevaert et al.

Summary: This study found that clinical phenogroups identified through unsupervised machine learning offer better prognostic information than LVEF categories, allowing for more effective risk stratification and assessment for heart failure patients.

ESC HEART FAILURE (2021)

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Review Cardiac & Cardiovascular Systems

Heart failure with preserved ejection fraction in humans and mice: embracing clinical complexity in mouse models

Coenraad Withaar et al.

Summary: HFpEF is a multifactorial disease with no proven therapy to improve outcomes, leading to challenges in drug development. Recent clinical algorithms aimed to improve and standardize the diagnosis of HFpEF. However, most pre-clinical HFpEF models do not fully meet clinical criteria, highlighting the need for novel approaches in model development.

EUROPEAN HEART JOURNAL (2021)

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Article Cardiac & Cardiovascular Systems

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Theresa A. McDonagh et al.

EUROPEAN HEART JOURNAL (2021)

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Article Cardiac & Cardiovascular Systems

Impact of epicardial adipose tissue on cardiovascular haemodynamics, metabolic profile, and prognosis in heart failure

Nicola R. Pugliese et al.

Summary: Echocardiographic epicardial adipose tissue (EAT) has different impacts and prognoses in heart failure (HF) patients, with high EAT levels associated with adverse effects in HFpEF patients and low EAT levels related to negative outcomes in HFrEF patients.

EUROPEAN JOURNAL OF HEART FAILURE (2021)

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Article Biochemistry & Molecular Biology

Subtypes identification on heart failure with preserved ejection fraction via network enhancement fusion using multi-omics data

Yongqing Wu et al.

Summary: Heart failure with preserved ejection fraction (HFpEF) is a syndrome associated with multiple etiologic and patho-physiologic factors, leading to increased cardiovascular morbidity and mortality. Therapeutic interventions for HFpEF face challenges, but identifying clinical subtypes using multi-omics data can help in efficient treatment and prognosis.

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Transcatheter InterAtrial Shunt Device for the treatment of heart failure: Rationale and design of the pivotal randomized trial to REDUCE Elevated Left Atrial Pressure in Patients with Heart Failure II (REDUCE LAP-HF II)

Natalia Berry et al.

AMERICAN HEART JOURNAL (2020)

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Sacubitril/Valsartan Across the Spectrum of Ejection Fraction in Heart Failure

Scott D. Solomon et al.

CIRCULATION (2020)

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Phenomapping of patients with heart failure with preserved ejection fraction using machine learning-based unsupervised cluster analysis

Matthew W. Segar et al.

EUROPEAN JOURNAL OF HEART FAILURE (2020)

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Machine Learning Prediction of Mortality and Hospitalization in Heart Failure With Preserved Ejection Fraction

Suveen Angraal et al.

JACC-HEART FAILURE (2020)

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Article Biotechnology & Applied Microbiology

Enhanced clinical phenotyping by mechanistic bioprofiling in heart failure with preserved ejection fraction: insights from the MEDIA-DHF study (The Metabolic Road to Diastolic Heart Failure)

Susan Stienen et al.

BIOMARKERS (2020)

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Therapeutic Targeting of Left Atrial Myopathy in Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction

Ravi B. Patel et al.

JAMA CARDIOLOGY (2020)

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Heart failure with preserved ejection fraction: A clustering approach to a heterogenous syndrome

Florian Schrub et al.

ARCHIVES OF CARDIOVASCULAR DISEASES (2020)

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The neglected issue of cardiac amyloidosis in trials on heart failure with preserved ejection fraction in the elderly

Domitilla Russo et al.

EUROPEAN JOURNAL OF HEART FAILURE (2020)

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Clinical Phenogroups in Heart Failure With Preserved Ejection Fraction Detailed Phenotypes, Prognosis, and Response to Spironolactone

Jordana B. Cohen et al.

JACC-HEART FAILURE (2020)

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Multiple Plasma Biomarkers for Risk Stratification in Patients With Heart Failure and Preserved Ejection Fraction

Julio A. Chirinos et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2020)

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Variation in clinical and patient-reported outcomes among complex heart failure with preserved ejection fraction phenotypes

Kelsey M. Flint et al.

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Proteomic Evaluation of the Comorbidity-Inflammation Paradigm in Heart Failure With Preserved Ejection Fraction Results From the PROMIS-HFpEF Study

Sandra Sanders-van Wijk et al.

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JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2020)

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Atrial Dysfunction in Patients With Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation

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Exercise Intolerance in Older Adults With Heart Failure With Preserved Ejection Fraction JACC State-of-the-Art Review

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Contribution of Cardiovascular Reserve to Prognostic Categories of Heart Failure With Preserved Ejection Fraction: A Classification Based on Machine Learning

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Regional Adipose Distribution and its Relationship to Exercise Intolerance in Older Obese Patients Who Have Heart Failure With Preserved Ejection Fraction

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