Left Ventricular Elastance With Resting Volumetric Transthoracic Echocardiography Identifies Different Phenotypes in Heart Failure With Preserved Ejection Fraction: A Retrospective Analysis of a Multicenter Prospective Observational Study
Key result
Hypercontractile and hypocontractile HFpEF phenotypes are linked to ~56% higher MACE risk than intermediate LV elastance.
- P=0.036
- n=2,380
Why the study?
HFpEF is a heterogeneous entity including different LV function phenotypes, and the value of resting LV elastance (force) using transthoracic echocardiography to identify these phenotypes was unknown.
Does resting left ventricular elastance measured by transthoracic echocardiography identify distinct phenotypes and prognostic risks in patients with HFpEF?
Population
2,380 patients with HFpEF
Comparison
Low force vs intermediate force vs high force groups
Design
Retrospective analysis of a multicenter prospective observational study
Follow-up
Median 16 months
Authors
Discussion
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Member takes
Implication
May stratify HFpEF prognosis via resting LV elastance; hypothesis-generating and should not yet change practice.
Study Design
Type
Observational (n=2,380)
Multicenter
Yes
Structured PICO
Does resting left ventricular elastance measured by transthoracic echocardiography identify distinct phenotypes and prognostic risks in patients with HFpEF?
P
Population
2,380 patients with heart failure with preserved ejection fraction, followed for a median of 16 months.
E
Exposure
Assessment of resting left ventricular elastance (force) using transthoracic echocardiography to stratify patients into three phenotypes: low force (<3.24 mm Hg/mL), intermediate force (3.24-5.48 mm Hg/mL), and high force (>5.48 mmHg/mL)
C
Comparator
Comparison among the three left ventricular elastance (force) groups
O
Outcome
Composite endpoint of major adverse cardiac events (MACEs) at median 16 months follow-upcomposite
Main Result
Absolute Event Rate: 22.9% vs 14.7%
p-value: p=0.036
Resting left ventricular elastance measured by volumetric transthoracic echocardiography can identify distinct HFpEF phenotypes, with hypercontractile and hypocontractile states associated with a higher risk of major adverse cardiac events.
Cite This Study
Wang et al. (2025) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=2,380). Resting left ventricular elastance (force) phenotypes vs. Intermediate force (3.24-5.48 mm Hg/mL) was evaluated on Composite of major adverse cardiac events (MACEs) (p=0.036). Resting LV elastance identified hypercontractile and hypocontractile HFpEF phenotypes, which had higher MACE rates (22.9% and 16.1% person-years) than the intermediate phenotype (14.7%; P=0.036).