Cardiac-renal-hepatic-metabolic disease in chronic heart failure (CARMEN-CHF): rationale and design of an observational multicenter prospective study

Components of cardiac-renal-hepatic-metabolic disease (CRHMD), such as atherosclerotic cardiovascular diseases combined with obesity, type 2 diabetes, chronic kidney disease, and metabolic-associated fatty liver disease, are widespread in the general population and are characterized by an unfavorable prognosis. Moreover, there are common mechanisms for the simultaneous involvement of various organs and systems in the pathological process, forming the CRHMD complex. Despite the proven association between the components of the CRHMB and the risk of developing and progressing to a more severe heart failure (HF) course, studies of their combinations in real-world practice are extremely limited. Cardiac-renal-hepatic-metabolic disease in chronic heart failure (CARMEN-CHF) is a multicenter observational study specifically designed to evaluate the incidence of CRHMD and its components in outpatients and hospitalized patients with verified pre-existing or clinically evident HF. The prospective design with a 2-year follow-up period will allow us to evaluate not only the baseline but also the cumulative incidence of CRHMD and its components over time, their prognostic significance in HF course, as well as the potential of modern therapy in reducing the risk of adverse cardiovascular events and death in various HF phenotypes. The role of drugs with proven cardiac-renal-hepatic-metabolic protective properties used in real-world practice on the course and prognosis of both HF and the main components of the CRHMD will be assessed.