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Uijl, AliciaUniv Utrecht, Netherlands; Karolinska Inst, Sweden; Univ Utrecht, Netherlands
(author)
Identification of distinct phenotypic clusters in heart failure with preserved ejection fraction
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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2021-05
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Wiley,2021
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:liu-175595
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-175595URI
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https://doi.org/10.1002/ejhf.2169DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:146420659URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies|Swedish National Board of Health and Welfare; Swedish Association of Local Authorities and Regions; Swedish Society of Cardiology; Swedish Heart-Lung FoundationSwedish Heart-Lung Foundation; Servier, the NetherlandsNetherlands Government; EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking BigData@Heart grant [116074]; Swedish Research CouncilSwedish Research CouncilEuropean Commission [2013-23897-104604-23, 523-2014-2336]; Swedish Heart Lung FoundationSwedish Heart-Lung Foundation [20150557, 20170841]; Stockholm County CouncilStockholm County Council [20140220, 20170112]; UCL Hospitals NIHR Biomedical Research Centre; Dutch Heart Foundation, as part of Facts and Figures
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Aims We aimed to derive and validate clinically useful clusters of patients with heart failure with preserved ejection fraction (HFpEF; left ventricular ejection fraction >= 50%). Methods and results We derived a cluster model from 6909 HFpEF patients from the Swedish Heart Failure Registry (SwedeHF) and externally validated this in 2153 patients from the Chronic Heart Failure ESC-guideline based Cardiology practice Quality project (CHECK-HF) registry. In SwedeHF, the median age was 80 [interquartile range 72-86] years, 52% of patients were female and most frequent comorbidities were hypertension (82%), atrial fibrillation (68%), and ischaemic heart disease (48%). Latent class analysis identified five distinct clusters: cluster 1 (10% of patients) were young patients with a low comorbidity burden and the highest proportion of implantable devices; cluster 2 (30%) patients had atrial fibrillation, hypertension without diabetes; cluster 3 (25%) patients were the oldest with many cardiovascular comorbidities and hypertension; cluster 4 (15%) patients had obesity, diabetes and hypertension; and cluster 5 (20%) patients were older with ischaemic heart disease, hypertension and renal failure and were most frequently prescribed diuretics. The clusters were reproduced in the CHECK-HF cohort. Patients in cluster 1 had the best prognosis, while patients in clusters 3 and 5 had the worst age- and sex-adjusted prognosis. Conclusions Five distinct clusters of HFpEF patients were identified that differed in clinical characteristics, heart failure drug therapy and prognosis. These results confirm the heterogeneity of HFpEF and form a basis for tailoring trial design to individualized drug therapy in HFpEF patients.
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Savarese, GianluigiKarolinska Institutet,Karolinska Inst, Sweden
(author)
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Vaartjes, IloncaUniv Utrecht, Netherlands
(author)
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Dahlström, UlfLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ulfda85
(author)
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Brugts, Jasper J.Erasmus MC Univ Med Ctr, Netherlands
(author)
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Linssen, Gerard C. M.Hosp Grp Twente, Netherlands; Hosp Grp Twente, Netherlands
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van Empel, VanessaMaastricht Univ, Netherlands
(author)
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Brunner-La Rocca, Hans-PeterMaastricht Univ, Netherlands
(author)
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Asselbergs, Folkert W.Univ Utrecht, Netherlands; UCL, England; UCL, England
(author)
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Lund, Lars H.Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
(author)
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Hoes, Arno W.Univ Utrecht, Netherlands
(author)
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Koudstaal, StefanUniv Utrecht, Netherlands; Groene Hart Ziekenhuis, Netherlands
(author)
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Karolinska InstitutetUniv Utrecht, Netherlands; Karolinska Inst, Sweden; Univ Utrecht, Netherlands
(creator_code:org_t)
Related titles
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In:European Journal of Heart Failure: Wiley23:6, s. 973-9821388-98421879-0844
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Linköping University
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