FIBFAR: Fenotipo hemodinámico-inflamatorio asociado con aterosclerosis carotídea subclínica en pacientes con riesgo cardiometabólico

Q: What are the key findings of this study?

The FIBFAR hemodynamic-inflammatory phenotype was independently associated with subclinical carotid plaque in patients with cardiometabolic risk (adjusted OR 8.60; 95% CI 4.39-17.70; p<0.001).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiometabolic risk (hypertension and diabetes mellitus or prediabetes) (n=243). Intervention: FIBFAR phenotype (low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype: hs-CRP >=2.5 mg/L, cardiac index 1600 dynes·s·cm-5) vs. Non-FIBFAR phenotypes (adaptive, inflammatory vasoconstrictor, or indeterminate). Primary outcome: Presence of subclinical carotid plaque assessed by Doppler ultrasound (OR 8.60, 95% CI 4.39-17.70, p=<0.001).

Q: What does this research mean for the field?

The FIBFAR hemodynamic-inflammatory phenotype is independently associated with subclinical carotid plaque in patients with cardiometabolic risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Paola Chong; Pedro Jose Forcada; Nicolas Mosteiro

doi:10.7775/rac.es.v94.i5.21044

October 29, 2026Revista Argentina de CardiologíaOpen Access

FIBFAR: Fenotipo hemodinámico-inflamatorio asociado con aterosclerosis carotídea subclínica en pacientes con riesgo cardiometabólico

View Full Paper

Ask AI

Bookmark

Share

Key result

FIBFAR phenotype linked to ~8.6-fold higher odds of subclinical carotid plaque in cardiometabolic risk.

OR 8.60
95% CI 4.39-17.70
P<0.001
n=243

Why the study?

Systemic inflammation and hemodynamic alterations are complementary mechanisms in cardiovascular disease, and identifying integrative phenotypes using noninvasive tools could better characterize subclinical atherosclerosis in patients with cardiometabolic risk.

Is the low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype (FIBFAR) associated with the presence of subclinical carotid plaque in outpatients with cardiometabolic risk?

Key Points

To evaluate the association between the low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype (FIBFAR) and carotid plaque in patients with cardiometabolic risk.
Observational, analytical, cross-sectional retrospective study of 243 outpatients aged ≥18 years with hypertension and diabetes mellitus or prediabetes.
Hemodynamic parameters (cardiac index and systemic vascular resistance) were measured by impedance cardiography, systemic inflammation by high-sensitivity C-reactive protein (hs-CRP), and carotid plaque by Doppler ultrasound.
The FIBFAR phenotype was defined as hs-CRP ≥2.5 mg/L, cardiac index <2.5 L/min/m², and systemic vascular resistance >1600 dynes•s•cm⁻⁵, evaluated via multivariable logistic regression.
The FIBFAR phenotype was independently associated with carotid plaque (OR 8.60; 95% CI: 4.39–17.70; p < 0.001), alongside age ≥65 years (OR 1.94; 95% CI: 1.01–3.72; p = 0.047).
The multivariable model demonstrated moderate discriminatory power (AUC = 0.73; 95% CI: 0.66–0.79; p < 0.001) and adequate calibration (Hosmer-Lemeshow p = 0.374).

Study Design

Type

Cross-Sectional (n=243)

Multicenter

No

Structured PICO

Is the low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype (FIBFAR) associated with the presence of subclinical carotid plaque in outpatients with cardiometabolic risk?

P

Population

243 adult outpatients (median age 58 years, 36.0% female) with concomitant hypertension and diabetes or prediabetes and BMI <=35 kg/m2 evaluated cross-sectionally at a single center in Argentina.

E

Exposure

FIBFAR hemodynamic-inflammatory phenotype, defined by hs-CRP ≥2.5 mg/L, cardiac index (CI) <2.5 L/min/m², and systemic vascular resistance (SVR) >1600 dynes·s·cm⁻⁵ measured by noninvasive impedance cardiography.

C

Comparator

Other hemodynamic-inflammatory phenotypes (adaptive: hs-CRP <2.5 mg/L, CI ≥2.5 L/min/m², SVR ≤1600 dynes·s·cm⁻⁵; inflammatory vasoconstrictor: hs-CRP ≥2.5 mg/L, CI ≥2.5 L/min/m², SVR >1600 dynes·s·cm⁻⁵; and indeterminate phenotype).

O

Outcome

Presence of subclinical carotid plaque assessed bilaterally by Doppler ultrasound (defined as focal thickening protruding into the arterial lumen or intima-media thickness ≥1.5 mm in any carotid segment).surrogate

Main Result

Odds Ratio: 8.6 (95% CI 4.39–17.7)

p-value: p=<0.001

Limitations

Cross-sectional design precludes establishing causal relationships, temporal sequences, or predictive capacity
Single-center cohort including exclusively patients with hypertension and diabetes mellitus or prediabetes, limiting generalizability
Cut-off points used to define the FIBFAR phenotype require validation in independent populations
Intraobserver and interobserver reproducibility of impedance cardiography was not formally evaluated in this cohort
Patients with BMI >35 kg/m2 were excluded due to technical limitations of impedance cardiography
Cross-sectional design precludes establishing causal relationships or predictive capacity, requiring prospective validation
Exclusion of patients with BMI >35 kg/m² due to technical limitations of impedance cardiography
Lack of formal assessment of intraobserver or interobserver variability within the study cohort
Cutoff points used to define the FIBFAR phenotype were not specifically developed for evaluating subclinical carotid atherosclerosis

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Integrating noninvasive hemodynamic parameters (low cardiac index and high systemic vascular resistance) with systemic inflammation (elevated hs-CRP) into the FIBFAR phenotype strongly identifies subclinical carotid atherosclerosis in patients with hypertension and diabetes or prediabetes.

Abstract

Background: Systemic inflammation and hemodynamic alterations represent complementary pathophysiological mechanisms involved in cardiovascular disease.The identification of integrative phenotypes using noninvasive tools could contribute to better characterization of subclinical atherosclerosis.Objective: To evaluate the association between the low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype (FIBFAR) and the presence of carotid plaque in patients with cardiometabolic risk, defined by the presence of hypertension and diabetes or prediabetes.Methods: An observational, analytical, cross-sectional study based on a retrospective analysis of 243 outpatients aged ≥18 years with hypertension and diabetes mellitus or prediabetes.Clinical, biochemical, and hemodynamic variables were analyzed, including high-sensitivity C-reactive protein (hs-CRP), cardiac index (CI), and systemic vascular resistance (SVR) measured by impedance cardiography.Carotid plaque was assessed using Doppler ultrasound.The association between FIBFAR (hs-CRP ≥2.5 mg/L, CI <2.5 L/min/m², and SVR >1600 dynes•s•cm -5 ) and carotid plaque was assessed using multivariate logistic regression.Results: The median age was 58 years (IQR 49-67), and 64.0% were male.The prevalence of carotid plaque was 37.0%.The FIBFAR phenotype was present in 23.0% of the cohort and was independently associated with carotid plaque (OR 8.60; 95% CI: 4.39-17.70;p < 0.001), along with age ≥65 years (OR 1.94; 95% CI: 1.01-3.72;p = 0.047).The model showed appropriate calibration (Hosmer-Lemeshow p = 0.374) and moderate discriminatory power (AUC = 0.73; 95% CI: 0.66-0.79;p < 0.001).Conclusions: In patients with cardiometabolic risk, the FIBFAR phenotype was independently associated with subclinical carotid atherosclerosis.Given the cross-sectional design, these findings should be interpreted as statistical associations and require prospective validation before their clinical application can be considered.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Chong et al. (2026) conducted a cross-sectional in Cardiometabolic risk (hypertension and diabetes mellitus or prediabetes) (n=243). FIBFAR phenotype (low-flow, high-systemic vascular resistance hemodynamic-inflammatory phenotype: hs-CRP >=2.5 mg/L, cardiac index <2.5 L/min/m2, and SVR >1600 dynes·s·cm-5) vs. Non-FIBFAR phenotypes (adaptive, inflammatory vasoconstrictor, or indeterminate) was evaluated on Presence of subclinical carotid plaque assessed by Doppler ultrasound (OR 8.60, 95% CI 4.39-17.70, p=<0.001). The FIBFAR hemodynamic-inflammatory phenotype was independently associated with subclinical carotid plaque in patients with cardiometabolic risk (adjusted OR 8.60; 95% CI 4.39-17.70; p<0.001).

synapsesocial.com/papers/6aebc8ba3e63ca1b6c315de7 https://doi.org/10.7775/rac.es.v94.i5.21044

View Full Paper

Ask AI

Bookmark

Share

FIBFAR: Fenotipo hemodinámico-inflamatorio asociado con aterosclerosis carotídea subclínica en pacientes con riesgo cardiometabólico

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

FIBFAR: Fenotipo hemodinámico-inflamatorio asociado con aterosclerosis carotídea subclínica en pacientes con riesgo cardiometabólico

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading