Rationale and design of the <scp>PREFERS</scp> (Preserved and Reduced Ejection Fraction Epidemiological Regional Study) Stockholm heart failure study: an epidemiological regional study in Stockholm county of 2.1 million inhabitants

Linde, Cecilia; Eriksson, Maria; Hage, Camilla; Wallén, Håkan; Persson, Bengt; Corbascio, Matthias; Lundeberg, Joakim; Maret, Eva; Persson, Hans

doi:10.1002/ejhf.599

Cited by 19 publications

(46 citation statements)

References 48 publications

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“…The study PREFERS Hypertension is the last part of the PREFERS ( Preserved and Reduced Ejection Fraction Epidemiological Regional Study in Stockholm , Clinical trial NCT03671122), a clinical trial first aiming at describing underlying pathophysiological mechanisms in new onset HF, either HFpEF or HFrEF with approximately 600 patients . PREFERS Hypertension study is a single‐centre, prospective clinical cohort study performed in collaboration between the Department of Cardiology at Danderyd Hospital and the Primary Health Care Services in Stockholm, Sweden.…”

Section: Methodsmentioning

confidence: 99%

“…We will follow current recommendations for echocardiography to record two‐dimensional echocardiographic and Doppler variables and perform Doppler tissue imaging similar to those measured in the PREFERS HF study ( Table ). All measurements will be presented as mean values of three cardiac cycles.…”

Section: Methodsmentioning

confidence: 99%

“…Thus, the aim of the present study is to characterize and study the timeline and the transition from uncomplicated hypertension to HHD and HFpEF in subjects with primary hypertension using advanced cardiac imaging techniques and bioinformatics ( Table ). Furthermore, we aim to compare changes of HFpEF variables and biomarkers in this study with patients with new onset symptomatic HFpEF in the Stockholm PREFERS Heart failure study …”

Section: Introductionmentioning

confidence: 99%

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The transition from hypertension to hypertensive heart disease and heart failure: the PREFERS Hypertension study

et al. 2020

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Aims Despite evidence-based therapeutic approaches, target blood pressure is obtained by less than half of patients with hypertension. Hypertension is associated with a significant risk for heart failure, in particular heart failure with preserved left ventricular (LV) ejection fraction (HFpEF). Although treatment is suggested to be given early after hypertension diagnosis, there is still no evidence-based medical treatment for HFpEF. We aim to study the underlying mechanisms behind the transition from uncomplicated hypertension to hypertensive heart disease (HHD) and HFpEF. To this end, we will combine cardiac imaging techniques and measurements of circulating fibrosis markers to longitudinally monitor fibrosis development in patients with hypertension. Methods and resultsIn a prospective cohort study, 250 patients with primary hypertension and 60 healthy controls will be characterized at inclusion and after 1 and 6 years. Doppler echocardiography, cardiac magnetic resonance imaging, and electrocardiogram will be used for measures of cardiac structure and function over time. Blood biomarkers reflecting myocardial fibrosis, inflammation, and endothelial dysfunction will be analysed. As a proxy for HFpEF development, the primary endpoint is to measure echocardiographic changes in LV function and structure (E/e′ and LAVI) and to relate these measures of LV filling to blood pressure, biomarkers, electrocardiogram, and cardiac magnetic resonance. Conclusions We aim to study the timeline and transition from uncomplicated hypertension to HHD and HFpEF. In order to identify subjects prone to develop HHD and HFpEF, we want to find biomarkers and cardiac imaging variables to explain disease progression. Ultimately, we aim at finding new pathways to prevent HFpEF.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The transition from hypertension to hypertensive heart disease and heart failure: the PREFERS Hypertension study

et al. 2020

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“…One subset of 100 patients undergoing elective coronary bypass surgery will also undergo myocardial biopsy and cardiac magnetic resonance imaging. The aim is to identify new biomarkers of disease progression and of pathophysiological mechanisms that can better characterize and compare patients with new‐onset HF, with a reduced or preserved ejection fraction, and find novel therapeutic targets …”

Section: The Prefers Designmentioning

confidence: 99%

“…The aim is to identify new biomarkers of disease progression and of pathophysiological mechanisms that can better characterize and compare patients with new-onset HF, with a reduced or preserved ejection fraction, and find novel therapeutic targets. 19…”

Section: The Prefers Designmentioning

confidence: 99%

October 2016 at a glance: treatment of heart failure

Metra

2016

European J of Heart Fail

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Baseline characteristics of 547 new onset heart failure patients in the PREFERS heart failure study

et al. 2022

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AimWe present the baseline characteristics of the PREFERS Stockholm epidemiological study on the natural history and course of new onset heart failure (HF) aiming to improve phenotyping focusing on HF with preserved left ventricular ejection fraction (HFpEF) pathophysiology. Methods and resultsNew onset HF patients diagnosed in hospital or at outpatient HF clinics were included at five Stockholm hospitals 2015-2018 and characterized by N-terminal pro brain natriuretic peptide (NT-proBNP), biomarkers, echocardiography, and cardiac magnetic resonance imaging (subset). HFpEF [left ventricular ejection fraction (LVEF) ≥ 50%] was compared with HF with mildly reduced LVEF (HFmrEF; LVEF 41-49%) and with HF with reduced LVEF (HFrEF; LVEF ≤ 40%). We included 547 patients whereof HFpEF (n = 137; 25%), HFmrEF (n = 61; 11%), and HFrEF (n = 349; 64%). HFpEF patients were older (76; 70-81 years; median; interquartile range) than HFrEF (67; 58-74; P < 0.001), more often women (49% vs. 30%; P < 0.001), and had significantly higher comorbidity burden. They more often had atrial fibrillation, hypertension, and renal dysfunction. NT-proBNP was lower in HFpEF (896; 462-1645 ng/L) than in HFrEF (1160; 563-2370; P = 0.005). In HFpEF, left ventricular (LV) diameters and volumes were smaller (P < 0.001) and septal and posterior wall thickness and relative wall thickness higher (P < 0.001). E/é ≥ 14 was present in 26% of HFpEF vs. 32% of HFrEF (P = 0.017) and left atrial volume index > 34 mL/m 2 in 57% vs. 61% (P = 0.040). HFmrEF patients were intermediary between HFpEF and HFrEF for LV mass, LV volumes, and RV volumes but had the highest proportion of left ventricular hypertrophy and the lowest proportion of elevated E/é. Conclusions Phenotype data in new onset HF patients recruited in a broad clinical setting showed that 25% had HFpEF, were older, more often women, and had greater comorbidity burden. PREFERS is well suited to further explore biomarker and imaging components of HFpEF pathophysiology and may contribute to the emerging knowledge of HF epidemiology. Clinical trial registration: Clinicaltrials.gov identifier: NCT03671122.

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Rationale and design of the PREFERS (Preserved and Reduced Ejection Fraction Epidemiological Regional Study) Stockholm heart failure study: an epidemiological regional study in Stockholm county of 2.1 million inhabitants

Abstract: In this epidemiological HF study with biopsy studies in a subset of patients, we aim to identify new biomarkers of disease progression and to find pathophysiological mechanisms to support explorations of new treatment regimens for HFpEF.

Cited by 19 publications

References 48 publications

The transition from hypertension to hypertensive heart disease and heart failure: the PREFERS Hypertension study

The transition from hypertension to hypertensive heart disease and heart failure: the PREFERS Hypertension study

October 2016 at a glance: treatment of heart failure

Baseline characteristics of 547 new onset heart failure patients in the PREFERS heart failure study

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