TY - JOUR T1 - Phenotyping of acute decompensated heart failure with preserved ejection fraction JF - Heart JO - Heart DO - 10.1136/heartjnl-2021-320270 SP - heartjnl-2021-320270 AU - Yohei Sotomi AU - Shungo Hikoso AU - Sho Komukai AU - Taiki Sato AU - Bolrathanak Oeun AU - Tetsuhisa Kitamura AU - Akito Nakagawa AU - Daisaku Nakatani AU - Hiroya Mizuno AU - Katsuki Okada AU - Tomoharu Dohi AU - Akihiro Sunaga AU - Hirota Kida AU - Masahiro Seo AU - Masamichi Yano AU - Takaharu Hayashi AU - Yusuke Nakagawa AU - Shunsuke Tamaki AU - Tomohito Ohtani AU - Yoshio Yasumura AU - Takahisa Yamada AU - Yasushi Sakata A2 - , Y1 - 2022/01/05 UR - http://heart.bmj.com/content/early/2022/01/04/heartjnl-2021-320270.abstract N2 - Objective The pathophysiological heterogeneity of heart failure with preserved ejection fraction (HFpEF) makes the conventional ‘one-size-fits-all’ treatment approach difficult. We aimed to develop a stratification methodology to identify distinct subphenotypes of acute HFpEF using the latent class analysis.Methods We established a prospective, multicentre registry of acute decompensated HFpEF. Primary candidates for latent class analysis were patient data on hospital admission (160 features). The patient subset was categorised based on enrolment period into a derivation cohort (2016–2018; n=623) and a validation cohort (2019–2020; n=472). After excluding features with significant missingness and high degree of correlation, 83 features were finally included in the analysis.Results The analysis subclassified patients (derivation cohort) into 4 groups: group 1 (n=215, 34.5%), characterised by arrythmia triggering (especially atrial fibrillation) and a lower comorbidity burden; group 2 (n=77, 12.4%), with substantially elevated blood pressure and worse classical HFpEF echocardiographic features; group 3 (n=149, 23.9%), with the highest level of GGT and total bilirubin and frequent previous hospitalisation for HF and group 4 (n=182, 29.2%), with infection-triggered HF hospitalisation, high C reactive protein and worse nutritional status. The primary end point—a composite of all-cause death and HF readmission—significantly differed between the groups (log-rank p<0.001). These findings were consistent in the validation cohort.Conclusions This study indicated the feasibility of clinical application of the latent class analysis in a highly heterogeneous cohort of patients with acute HFpEF. Patients can be divided into 4 phenotypes with distinct patient characteristics and clinical outcomes.Trial registration number UMIN000021831.No data are available. Our study data will not be made available to other researchers for purposes of reproducing the results because of institutional review board restrictions. ER -