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Clinical Phenotypes of Heart Failure across the spectrum of Ejection Fraction: A Cluster Analysis.
Gouda, Pishoy; Alemayehu, Wendimagegn; Rathwell, Sarah; Ian Paterson, D; Anderson, Todd; Dyck, Jason R B; Howlett, Jonathan G; Oudit, Gavin Y; McAlister, Finlay A; Thompson, Richard B; Ezekowitz, Justin.
Afiliación
  • Gouda P; University of Alberta, Canadian VIGOUR Centre, Edmonton, Alberta, Canada; University of Alberta, Division of Cardiology, Edmonton, Alberta, Canada.
  • Alemayehu W; University of Alberta, Canadian VIGOUR Centre, Edmonton, Alberta, Canada.
  • Rathwell S; University of Alberta, Canadian VIGOUR Centre, Edmonton, Alberta, Canada.
  • Ian Paterson D; University of Alberta, Division of Cardiology, Edmonton, Alberta, Canada.
  • Anderson T; Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Dyck JRB; Cardiovascular Research Centre, Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • Howlett JG; Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Oudit GY; University of Alberta, Division of Cardiology, Edmonton, Alberta, Canada.
  • McAlister FA; University of Alberta, Canadian VIGOUR Centre, Edmonton, Alberta, Canada.
  • Thompson RB; Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
  • Ezekowitz J; University of Alberta, Canadian VIGOUR Centre, Edmonton, Alberta, Canada; University of Alberta, Division of Cardiology, Edmonton, Alberta, Canada. Electronic address: jae2@ualberta.ca.
Curr Probl Cardiol ; 47(11): 101337, 2022 Nov.
Article en En | MEDLINE | ID: mdl-35878816
INTRODUCTION: Heart failure (HF), and especially HF with preserved ejection fraction (HFpEF), remains a challenging condition to define. The heterogenous nature of this population may be related to a variety of underlying etiologies interacting myocardial dysfunction. METHOD: Alberta HEART study was a prospective, observational cohort that enrolled participants along the spectrum of heart failure including: healthy controls, people at risk of HF, and patients with HF and preserved (HFpEF) or reduced ejection fraction (HFrEF). We aimed to explore phenotypes of patients with HF and at-risk of developing HF. Utilising 27 detailed clinical, echocardiographic and biomarker variables, latent class analysis with and without multiple imputation was undertaken to identify distinct clinical phenotypes. RESULTS: Of 621 participants, 191 (30.8%) and 169 (27.2%) were adjudicated by cardiologists to have HFpEF and HFrEF respectively. In the overall cohort, latent class analysis identified four distinct phenotypes. Phenotype A (n=152, 24.5%) was a healthy and low risk group. Phenotype B (n=129, 20.8%) demonstrated increased left ventricular mass and end-diastolic volumes, with elevated natriuretic peptides and clinical features of congestion. Phenotype C (n=128, 20.6%) was primarily characterised by obesity (80%) and normal indexed cardiac chamber sizes, low natriuretic peptide levels and minimal features of congestion.  Phenotype D (n=212, 34.1%) consisted of elderly patients with clinical features of congestions. Phenotypes B and D demonstrated the highest risk of mortality and hospitalization over a median follow-up of 3.7 years. CONCLUSION: Phenotypes with congestive features demonstrated increased risk profiles. Heart failure is a heterogenous classification which requires further work to appropriately categorise patients based on the underlying etiology or mechanism of impairment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Curr Probl Cardiol Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insuficiencia Cardíaca Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Curr Probl Cardiol Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Países Bajos