Overview
Patients with HFpEF who have undergone meticulous clinical and instrumental evaluation (including diastolic exercise testing) between 2013 and 2020, will be followed up for at least 3 years.
Description
Heart failure with preserved ejection fraction (HFpEF) is a serious condition with an unfavorable prognosis.
The investigators aimed to evaluate in patients with HFpEF:
- the prognostic significance of standard resting hemodynamic parameters compared to key cardiac reserves;
- the prognostic significance of clinical parameters (sex, age, NYHA class, extra-cardiac diseases, therapy);
- the prognostic significance of biological markers of hemodynamic stress and biomarkers of inflammation and fibrosis;
- to identify independent predictors of adverse prognosis of HFpEF.
Eligibility
Inclusion Criteria:
- Signed and data informed consent;
- New York Heart Association (NYHA) class II-III heart failure;
- Left ventricular ejection fraction > 50%;
- Elevated LV filling pressures assessed by echocardiography at rest or at peak exercise.
Exclusion Criteria:
- Evidence of myocardial ischemia during stress echocardiography;
- Significant lesions of the main coronary arteries;
- Genetic forms of HFpEF (HCM, amyloidosis, Fabry disease, glycogen storage diseases etc.);
- Peripartum cardiomyopathy, chemotherapy-induced cardiomyopathy, viral myocarditis, isolated right-sided HF without left-sided structural disease, constrictive pericarditis, significant pericardial effusion;
- Significant lung disease (severe lung disease requiring home oxygen or chronic oral steroid therapy);
- Primary pulmonary artery hypertension;
- Significant left-sided structural valve disease;
- Anemia (Hb < 100 g/L);
- Impaired renal function, defined as estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 (CKD-EPI);
- Non-cardiac conditions that complicate/exclude participation in the study;
- Exacerbation of heart failure less than 3 months prior to study entry.