Predictors of Poor Prognosis in HFpEF

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.

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.