The goal of this observational study is to learn how people with Heart Failure with Preserved Ejection Fraction (HFpEF) can be grouped into different "phenotypes" based on their clinical information. The researchers want to understand whether these groups have different health profiles and different responses during a cardiopulmonary exercise test (CPET).
The main questions this study aims to answer are:
* Can clinical data be used to identify meaningful HFpEF phenotypes? * Do these phenotypes match well-known HFpEF scores, such as the H2FPEF and Heart Failure Association Pre-test Assessment, Echocardiography and Natriuretic Peptide (HFA-PEFF) scores? * Do people in different phenotypes show different results on a CPET?
Participants will:
* Have their past clinical records reviewed if they were diagnosed with HFpEF at the Local Health Unit of the Leiria Region (ULS RL); * A smaller group will attend one visit to complete a CPET, which measures how the heart, lungs and muscles respond during exercise.
This study includes adults aged 18 years or older who have HFpEF. The study does not involve any new treatments or experimental drugs.
Age ≥18 years;
Established diagnosis of heart failure with preserved ejection fraction (LVEF ≥50%);
Patients receiving care (outpatient or inpatient) at the Local Health Unit of the Leiria Region (ULS RL) since September 2018.
Age ≥18 years;
Incomplete or inadequate medical records preventing full data extraction.
Medical contraindication or physical inability to perform cardiopulmonary exercise testing (CPET);
Inability to provide informed consent.
Adult patients (≥18 years) with a confirmed diagnosis of heart failure with preserved ejection fraction (LVEF ≥50%) admitted in the Local Health Unit of the Leiria Region since September 2018. The retrospective phase includes electronic health records from approximately 200 patients, used to obtain multimodal datasets for unsupervised clustering. A cross-sectional phase recruits volunteer participants selected for representativeness of the identified phenotypes to undergo cardiopulmonary exercise testing (CPET) for functional characterization. Collected data include sociodemographic variables, clinical history, imaging findings, laboratory biomarkers (e.g., NT-proBNP), therapeutic data and CPET-derived functional parameters.
Cohort
Retrospective
Not listed
Identification and characterization of HFpEF phenotypes using multimodal clustering analysis
Identification of distinct phenotypic clusters in patients with heart failure with preserved ejection fraction using unsupervised machine learning applied to multimodal clinical, biochemical, imaging and functional data.
Mean peak oxygen uptake (VO₂peak) during cardiopulmonary exercise testing
Peak oxygen uptake (VO₂peak), expressed in mL·kg-¹·min-¹, measured by breath-by-breath gas analysis during maximal cardiopulmonary exercise testing and compared across HFpEF phenotypes.
Concordance between H2FPEF and HFA-PEFF scores and identified HFpEF phenotypes
Assessment of concordance and discrimination performance of H2FPEF and HFA-PEFF scores in identifying phenotypes derived from data-driven clustering.
Mean plasma NT-proBNP concentration (pg/mL) by HFpEF phenotypes
Comparison of plasma NT-proBNP concentrations (pg/mL) between HFpEF phenotypes identified by clustering analysis.
Click on the lead sponsor to view all of their trials.
Instituto Politécnico de Leiria
Lead sponsor
Faculty of Medicine of Universidade de Lisboa (FMUL)
Collaborator
Hospital Santo André - Centro Hospitalar de Leiria
Collaborator
Fundação para a Ciência e a Tecnologia (FCT)
Collaborator
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