Value of Intense Phenotyping in Heart Failure With Preserved Ejection Fraction
Heart failure (HF) with a left ventricular ejection fraction (LVEF) \>0.40 is a large medical problem, for which no drug or device has a recommendation in current HF guidelines. The prevalence of mortality and HF hospitalizations in HF with LVEF \>0.40 is high, but the identification of predictors for increased risk of mortality and HF hospitalizations in this patient category remains difficult. The hypothesis of this study is that the risk of all-cause mortality and HF hospitalizations can be measured by clinical factors, imaging parameters and circulating biomarkers, and that these factors can be used in a risk profile
⁃ Clinical criteria:
• Age \>18 years
• Written informed consent
• HF with moderate to severe symptoms NYHA II or III
• Hospitalization or emergency room visit for HF or symptom relief with diuretics
• Sinus rhythm or AF
⁃ Echocardiographic criteria:
• LVEF \>0.40
• Left atrial size (volume ≥29 mL/m2 or LA parasternal diameter ≥45), or left ventricular hypertrophy (septal thickness or posterior wall thickness ≥11 mm) or LV diastolic dysfunction (E/e' ≥13 or mean e' septal and lateral wall \<9 cm/s).
⁃ Biomarker criteria:
• BNP \>31ng/L or NT-pro-BNP\>125ng/L if sinus rhythm
• BNP \>75ng/L or NT-pro-BNP\>300ng/L if atrial fibrillation