Profiling heart failure with preserved or mildly reduced ejection fraction by cluster analysis
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Significant knowledge gaps remain regarding the heterogeneity of heart failure (HF) phenotypes, particularly among patients with preserved or mildly reduced left ventricular ejection fraction (HFp/mrEF). Our aim was to identify HF subtypes within the HFp/mrEF population. METHODS: K-prototypes clustering algorithm was used to identify different HF phenotypes in a cohort of 2570 patients diagnosed with heart failure with mildly reduced ejection fraction or heart failure with preserved left ventricular ejection fraction. This algorithm employs the k-means algorithm for quantitative variables and k-modes for qualitative variables. RESULTS: We identified three distinct phenotypic clusters: Cluster A (n = 850, 33.1%), characterized by a predominance of women with low comorbidity burden; Cluster B (n = 830, 32.3%), mainly women with diabetes mellitus and high comorbidity; and Cluster C (n = 890, 34.5%), primarily men with a history of active smoking and respiratory comorbidities. Significant differences were observed in baseline characteristics and 1-year mortality rates across the clusters: 18% for Cluster A, 33% for Cluster B, and 26.4% for Cluster C (P < 0.001). Cluster B had the shortest median time to death (90 days), followed by Clusters C (99 days) and A (144 days) (P < 0.001). Stratified Cox regression analysis identified age, cancer, respiratory failure, and laboratory parameters as predictors of mortality. CONCLUSION: Cluster analysis identified three distinct phenotypes within the HFp/mrEF population, highlighting significant heterogeneity in clinical profiles and prognostic implications. Women were classified into two distinct phenotypes: low-risk women and diabetic women with high mortality rates, while men had a more uniform profile with a higher prevalence of respiratory disease.
Authors: Lourdes Vicent, Nicolás Rosillo, Jorge Vélez, Guillermo Moreno, Pablo Pérez, José Luis Bernal, Germán Seara, Rafael Salguero-Bodes, Fernando Arribas, Héctor Bueno
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Tako-Tsubo - Brain Project. Estudio para identificar los mecanismos psicológicos, neuropsicológicos y neurofisiológicos del síndrome de Tako-Tsubo, G2537530979, G3986009405, G441766136, Estudio del papel de la inflamación dependiente de neutrófilos en la fisiopatología del infarto agudo de miocardio y sus complicaciones: En busca de nuevas dianas y oportunidades terapéuticas, G6214786725
OpenAlex ID: W4401467179