Characterization of Heart Failure With Preserved Ejection Fraction

Study Overview
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Brief Summary
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The goals of this research will be to define some of the mechanisms underlying the progression and complications of heart failure (HF) with preserved left ventricular ejection fraction (HFPEF) Aim 1: to evaluate the differences in cardiac structure, function and fibrosis markers through the spectrum of HF stages in order to deepen the understanding of the pathophysiology driving HF progression. Aim 2: to define the mechanisms by which HF risk factors, such as hypertension, diabetes, obesity, and renal insufficiency, interact with age to increase HF risk, and to evaluate the role of precipitating factors such as myocardial ischemia, atrial fibrillation in HFPEF. Aim 3: to determine prognostic factors in HFPEF patients, by following these patients over time. Accordingly the investigators will correlate baseline data (echocardiographic, MRI or biomarkers) with incident cardiovascular events and determine whether these measures provide incremental prognostic information beyond clinical characteristics.

Official Title
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Characterization of Heart Failure With Preserved Ejection Fraction

Conditions
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Fibrosis Estimated by cMR Ant Biomarkers

Intervention / Treatment
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* Diagnostic Test: cMR
* Biological: biomarker


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: We intend to recruit consecutive patients admitted for HFPEF in our institution during the next 4 years. Eligible patients include those with age ≥50 years, LVEF ≥45%, symptomatic HF, and either a hospitalization for HF within the prior year or an elevated natriuretic peptide level (BNP ≥100 pg/mL or NT-proBNP ≥360 pg/mL) within the 60 days before inclusion. Exclusion Criteria: Patients with uncontrolled hypertension, significant valvular disease or with known infiltrative or hypertrophic cardiomyopathy will be excluded.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The investigators will compare two different groups: controles and HFpEF patients, in order to better understand pathophysiology in HF with preserved ejection fraction.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: HFpEF<br>We intend to recruit consecutive patients admitted for HFPEF in our institution during the next 4 years. Eligible patients include those with age ≥50 years, LVEF ≥45%, symptomatic HF, and either a hospitalization for HF within the prior year or an elevated natriuretic peptide level (BNP ≥100 pg/mL or NT-proBNP ≥360 pg/mL) within the 60 days before inclusion. Intervention: cMR | Diagnostic Test: cMR<br>* cardiac MRI done to complete the diagnosis<br>Biological: biomarker<br>* Biomarker correlation with cMR parameters Prognostic information<br>|
| Active Comparator: Controls<br>We plan to recruit 10 per decade of age. These subjects will allow us to evaluate the effects of age on the parameters of our study. They will have no risk factors, a normal ECG at rest and normal heart ultrasound and no abnormalities on a stress test. Intervention: cMR | Diagnostic Test: cMR<br>* cardiac MRI done to complete the diagnosis<br>Biological: biomarker<br>* Biomarker correlation with cMR parameters Prognostic information<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prognosis with a follow up including HF hospitalizations and/or deaths. | A follow up will be done by the investigators. After that, they will determine if fibrosis estimated by cMR or biomarkers is a significant prognostic factor. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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heart failure with preserved ejection fraction, Imaging, Prognosis