Phenotypic Trajectories From Acute to Stable Phase in Heart Failure With Preserved Ejection Fraction: Insights From the PURSUIT‐HFpEF Study

作者：Yuki Matsuoka, Yohei Sotomi, Daisaku Nakatani, Katsuki Okada, Akihiro Sunaga, Hirota Kida, Taiki Sato, Daisuke Sakamoto, Tetsuhisa Kitamura, Sho Komukai, Masahiro Seo, Masamichi Yano, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Shunsuke Tamaki, Yoshio Yasumura, Takahisa Yamada, Shungo Hikoso, Yasushi Sakata, the OCVC‐Heart Failure Investigators · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.124.037567 · 被引用次数：12 · 研究领域：Heart Failure Treatment and Management、Cardiovascular Function and Risk Factors、Cardiac Fibrosis and Remodeling

BACKGROUND: Using machine learning for the phenotyping of patients with heart failure with preserved ejection fraction (HFpEF) has emerged as a novel approach to understanding the pathophysiology and stratifying the patients. Our objective is to perform phenotyping of patients with HFpEF in stable phase and to investigate the phenotypic trajectory from acute worsening phase to stable phase. METHODS: The present study is a post hoc analysis of the PURSUIT-HFpEF (Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) study. We applied the latent class analysis to the discharge data of patients hospitalized for acute decompensated heart failure. RESULTS: We finally included patient data of 1100 cases and 63 features in the latent class analysis. All patients were subclassified into 5 phenogroups as follows: Phenotype 1, characterized by better renal function and lower NT-proBNP (N-terminal pro-B-type natriuretic peptide) level [N=325 (29.5%)]; Phenotype 2, higher blood pressure, sinus rhythm, and poor renal function. [N=242 (22.0%)]; Phenotype 3, higher prevalence of atrial fibrillation, higher tricuspid pressure gradient, and lower tricuspid annular plane systolic excursion [N=214 (19.5%)]; Phenotype 4, higher C-reactive protein level and higher tricuspid pressure gradient [N=245 (22.3%)]; and Phenotype 5, poor nutritional status, poor renal function, and higher NT-proBNP level [N=74 (6.7%)]. A particular phenotype observed ...