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Study Aim is creation of the Hospital Register of patients with heart failure with preserved ejection fraction (HFpEF) for a comprehensive assessment of the influence of gender characteristics, clinical and anamnestic factors, body composition, topical characteristics of congestion, instrumental data and markers of cellular inflammation and stress on immediate and long-term outcomes in patients with acute decompensated heart failure with preserved ejection fraction.
During the study it is planned to assess gender, clinical and anamnestic indicators preceding hospitalization of patients in the hospital; characterize the features of comorbid status in the studied group of patient; study the features of drug therapy at the prehospital stage and during hospitalization in the study group of patient; assess adverse hospital outcomes and outcomes 6 months after hospital discharge and identify factors associated with them; assess body composition in patients with acute decompensated heart failure with preserved ejection fraction in obese patients upon admission to the hospital; characterize the severity and topical characteristics of congestion and compare with the phenotypes of acute decompensation of heart failure; asess adverse in-hospital outcomes and outcomes 6 months after hospital discharge and identify factors associated with them; conduct a clinical and instrumental examination of patients diagnosed with compensated and decompensated HFpEF, verified by echocardiography at rest, as well as in patients with HFpEF verified after an additional diastolic stress test with assessment of intracardiac hemodynamic; analyze the serum concentrations of biochemical markers associated with cellular stress in these groups of patients, as well as in the control group of apparently healthy people; conduct an analysis of associations of biomarker levels with clinical characteristics of patients, the presence of comorbid diseases, including obesity, as well as with data from instrumental examination methods; assess the diagnostic capabilities of HFpEF, defined by various criteria, based on the concentration of the new biomarkers The results obtained will allow us to evaluate the characteristics of the course and outcomes of the disease in Moscow patients, depending on the phenotype of acute decompensation of HFpEF, hospitalized in the hospital during the study period. It is expected to identify phenotypes of acute decompensation of HFpEF that affect the duration of hospitalization and the development of adverse outcomes in the hospital and long-term period of the disease.
Full description
THE RELEVANCE OF RESEARCH Identifying patients with heart failure with preserved ejection fraction (HFpEF) represents a significant public health challenge. In a significant proportion of patients with HFpEF, no specific underlying etiology has been identified, with the exception of cardiovascular risk factors such as hypertension, obesity, diabetes mellitus, the presence of atrial fibrillation, and others. Many of these patients are classified as having hypertension and do not receive the necessary amount of preventive interventions aimed at reducing hospitalizations and increasing life expectancy. The incidence of hospitalization for acute decompensated heart failure is increasing, mainly due to acute HFpEF. It is hypothesized that systemic inflammation resulting from comorbidities such as obesity, diabetes mellitus, and hypertension is responsible for the pathogenesis of myocardial structural and functional changes in HFpEF. Therefore, assessment of clinical and anamnestic factors and their relationship with signs of structural changes, functional disorders of intracardiac hemodynamics, signs of congestion and systemic inflammation will help optimize the diagnostic and treatment algorithm for patients with acute decompensation of HFpEF.
In this context, additional markers such as body composition measures, ultrasound congestion criteria, and cellular stress-related biomarkers may complement or even surpass traditional markers in predicting the severity and prognosis of HFpEF.
The creation of a register and analysis of the data entered into it will help improve the comprehensive diagnosis of decompensated HFpEF
PURPOSE OF THE STUDY:
Creation of a register of patients with HFpEF for a comprehensive assessment of the influence of gender characteristics, clinical and anamnestic factors, body composition, topical characteristics of congestion, instrumental data and markers of cellular inflammation and stress on immediate and long-term outcomes in patients with acute decompensated heart failure with preserved ejection fraction.
During the study it is planned
STUDY DESIGN:
Descriptive, open-label, observational study, randomization procedure not planned.
STAGES OF RESEARCH:
It is planned to create a database, followed by:
filling out the consent
creation of a research registration card indicating:
Stage 2 - determining the nearest outcomes - In-hospital outcomes: death with indication of the cause of death, transfer with aggravation to another department of the hospital, discharged
Stage 3 - assessment of long-term outcomes after 6 months, which includes:
EXPECTED RESULTS The results obtained will allow us to evaluate the characteristics of the course and outcomes of the disease in Moscow patients, depending on the phenotype of acute decompensation of HFpEF, hospitalized in the hospital during the study period. When studying a cohort of patients hospitalized for emergency reasons, it is expected to identify phenotypes of acute decompensation of HFpEF that affect the duration of hospitalization and the development of adverse outcomes in the hospital and long-term period of the disease.
The prospects for further use in clinical practice of analysis of circulating levels of heat shock proteins in combination with other clinical and instrumental methods will be analyzed. Based on the data obtained, it is planned to develop laboratory and instrumental algorithms for additional assessment in patients with HFpEF.
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Inclusion criteria
All patients hospitalized with a clinical picture of acute decompensation of heart failure (shortness of breath, orthopnea, clinical signs of "cardiac asthma" and/or "pulmonary edema") in the city clinical hospital named after. V.V. Veresaeva, Moscow. Patients with a confirmed diagnosis in accordance with instrumental (EchoCG) and/or laboratory criteria.
Exclusion criteria
Refusal to sign informed consent to participate in a clinical trial and to process personal data.
160 participants in 2 patient groups
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Central trial contact
Yury Timofeev, phD
Data sourced from clinicaltrials.gov
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