Sex-specific cardiometabolic multimorbidity, metabolic syndrome and left ventricular function in heart failure with preserved ejection fraction in the UK Biobank
Authors' conclusion
Women with cardiometabolic HFpEF had a lower comorbidity burden compared to men despite a similar metabolic syndrome profile. Based on patients' cardiometabolic profile, we identified three distinct subgroups which differed in body shape and mass, lipid biomarker and medication profile, as well as in cardiac output at rest both in men and women. These factors may affect disease trajectory, treatment options and outcomes in those subgroups. Subject to further validation, our findings provide a refined characterisation of the cardiometabolic HFpEF phenotype, contributing towards a better understanding of the condition to enable phenotype-specific disease management.
Study context
- Population
- UK Biobank participants with heart failure with preserved ejection fraction (HFpEF) (ICD-10 I50 HF diagnosis plus cardiac magnetic resonance (CMR)-derived left ventricular ejection fraction (LVEF) ≥ 50%); median age 70 years (IQR 66.0–74.0)
- Participants
- 445 participants
- Exposure
- Sex-specific cardiometabolic profiles and latent class analysis (LCA)-derived phenogroups in HFpEF
- Menn = 299
- Womenn = 146
- Group 1n = 117
- Group 2n = 116
- Group 3n = 212
- Outcome
- Cardiometabolic comorbidity burden and phenogroups
Methodological detailsmodified cross-sectional, latent class analysis, multicentre (UK Biobank)
- Modified cross-sectional
- Latent class analysis
- Multicentre (UK Biobank)
Main finding
As reported in the abstract
- LCA revealed three distinct, clinically relevant phenogroups
- 3
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| Cardiac output at rest, malesGroup 2 vs Group 3 · higher in group 2 | Group 2 median 5.6 L/min · Group 3 median 5.2 L/min | P < 0.05 |
| Cardiac output at rest, femalesGroup 2 vs Group 3 · higher in group 2 | Group 2 5.1 L/min · Group 3 4.4 L/min | P < 0.01 |
| Global longitudinal strain, womenGroup 1 vs Group 2 · absolute GLS lower in group 1 | Group 1 −17.6% · Group 2 −18.5% | P < 0.05 |
Original publication
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