Aims: Approximately 50% of patients with heart failure have preserved (≥50%) ejection fraction (HFpEF). Improved understanding of the phenotypic heterogeneity of HFpEF might facilitate development of targeted therapies and interventions.
Methods: This retrospective study characterized a cohort of patients with HFpEF based on similar clinical profiles and evaluated 1-year heart failure related hospitalization. Enrolment, medical and pharmacy data were used to identify patients newly diagnosed with heart failure enrolled in a Medicare Advantage Prescription Drug or commercial healthcare plan. To identify only those patients with HFpEF, we used natural language processing techniques of ejection fraction values abstracted from a linked free-text clinical notes data source. The study population comprised 1515 patients newly identified with HFpEF between 1 January 2011 and 31 December 2015.
Results: Using unsupervised machine learning, we identified three distinguishable patient clusters representing different phenotypes: cluster-1 patients had the lowest prevalence of heart failure comorbidities and highest mean age; cluster-2 patients had higher prevalence of metabolic syndrome and pulmonary disease, despite younger mean age; and cluster-3 patients had higher prevalence of cardiac arrhythmia and renal disease. Cluster-3 had the highest 1-year heart failure related hospitalization rates. Within-cluster analysis, prior use of diuretics (cluster-1 and cluster-2) and age (cluster-2 and cluster-3) was associated with 1-year heart failure related hospitalization. Combination therapy was associated with decreased 1-year heart failure related hospitalization in cluster-1.
Conclusion: This study demonstrated that clustering can be used to characterize subgroups of patients with newly identified HFpEF, assess differences in heart failure related hospitalization rates at 1 year and suggest patient subtypes may respond differently to treatments or interventions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2459/JCM.0000000000001116 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between stress hyperglycemia ratio and mortality in patients with heart failure complicated by sepsis.
Sci Rep
December 2024
The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Nanjing, China, 214000.
Individuals afflicted with heart failure complicated by sepsis often experience a surge in blood glucose levels, a phenomenon known as stress hyperglycemia. However, the correlation between this condition and overall mortality remains unclear. 869 individuals with heart failure complicated by sepsis were identified from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and categorized into five cohorts based on their stress hyperglycemia ratio (SHR).
View Article and Find Full Text PDFReal-world evaluation of intracardiac echocardiography guided radio-frequency catheter ablation for atrial fibrillation: a retrospective cohort study.
Sci Rep
December 2024
Department of Cardiology, West China Hospital of Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China.
Intracardiac echocardiography (ICE) has been used to guide radio-frequency catheter ablation (RFCA) for better catheter navigation and less radiation exposure in treating atrial fibrillation (AF). This retrospective cohort study enrolled 227 AF patients undergoing ICE- or traditional fluoroscopy (TF)-guided RFCA for AF in a tertiary hospital. ICE was used more often in patients with atrial tachycardia [odds ratio (OR) 3.
View Article and Find Full Text PDFTranscriptomic and genetic profiling in a spontaneous non-human primate model of hypertrophic cardiomyopathy and sudden cardiac death.
Sci Rep
December 2024
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr, Raleigh, NC, 27607, USA.
Hypertrophic cardiomyopathy (HCM) afflicts humans, cats, pigs, and rhesus macaques. Disease sequelae include congestive heart failure, thromboembolism, and sudden cardiac death (SCD). Sarcomeric mutations explain some human and cat cases, however, the molecular basis in rhesus macaques remains unknown.
View Article and Find Full Text PDFHypoxia-induced TPC2 transcription and glycosylation aggravates pulmonary arterial hypertension by blocking autophagy flux.
Sci Rep
December 2024
Department of Respiratory Medicine, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), No. 61 Jiefang Xi Road, Changsha, Hunan, 410219, China.
Pulmonary arterial hypertension (PAH) is a serious medical condition that causes a failure in the right heart. Two-pore channel 2 (TPC2) is upregulated in PAH, but its roles in PAH remain largely unknown. Our investigation aims at the mechanisms by which TPC2 regulates PAH development.
View Article and Find Full Text PDFMitochondrial transplantation normalizes transcriptomic and proteomic shift associated with ischemia reperfusion injury in neonatal hearts donated after circulatory death.
Sci Rep
December 2024
Department of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
Heart transplantation remains the ultimate treatment strategy for neonates and children with medically refractory end-stage heart failure and utilization of donors after circulatory death (DCD) can expand th donor pool. We have previously shown that mitochondrial transplantation preserves myocardial function and viability in neonatal swine DCD hearts to levels similar to that observed in donation after brain death (DBD). Herein, we sought to investigate the transcriptomic and proteomic pathways implicated in these phenotypic changes using ex situ perfused swine hearts.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!