{"title":"伴有左心室射血分数异常的心力衰竭的临床和血浆蛋白质组学特征：心力衰竭的一个新兴实体","authors":"Yasuhiko Sakata, Kotaro Nochioka, Satoshi Yasuda, Koichi Ishida, Takashi Shiroto, Jun Takahashi, Shintaro Kasahara, Ruri Abe, Shinsuke Yamanaka, Takahide Fujihashi, Hideka Hayashi, Shintaro Kato, Katsunori Horii, Kanako Teramoto, Tsutomu Tomita, Satoshi Miyata, Koichiro Sugimura, Iwao Waga, Masao Nagasaki, Hiroaki Shimokawa","doi":"10.1002/ejhf.3654","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>The clinical guidelines categorize heart failure (HF) based on left ventricular ejection fraction (LVEF). However, the current LVEF cutoffs, 40% and 50%, may not fully address the underlying characteristics and cardiovascular risk of HF, particularly for HF with higher LVEF. This study aimed to characterize HF with supranormal ejection fraction (HFsnEF) using different LVEF cutoffs (35%, 55%, and 70% for men, and 40%, 60%, and 75% for women).</p>\n </section>\n \n <section>\n \n <h3> Methods and results</h3>\n \n <p>This study divided 442 patients from the CHART-Omics study into four groups: HF with reduced ejection fraction (HFrEF) (<i>n</i> = 55, 65.5 years), HF with mildly reduced ejection fraction (HFmrEF) (<i>n</i> = 125, 69.3 years), HF with normal ejection fraction (HFnEF) (<i>n</i> = 215, 69.0 years) and HFsnEF (<i>n</i> = 47, 67.1 years). When clinical backgrounds were adjusted and HFnEF served as the reference, HFsnEF carried an increased hazard ratio (HR) for the composite of cardiovascular death and HF hospitalization of 2.71 (95% confidence interval [CI] 1.10–6.66, <i>p</i> = 0.030), while HFrEF had a HR of 3.14 (95% CI 1.36–7.23, <i>p</i> = 0.007). HFsnEF was characterized by an increase in relative left ventricular wall thickness and a decrease in left ventricular dimensions, whereas increased left ventricular mass and dimensions characterized HFrEF. Quantitative analysis of 4670 plasma proteins showed essential differences between HFsnEF and HFrEF, for example, ‘protein synthesis’ versus ‘cell morphology’, ‘cellular assembly and organization’ and ‘nucleic acid metabolism’ for underlying pathophysiology, and ‘energy production’ versus ‘connective tissue disorders’ and ‘cell-to-cell signalling and interaction’ for prognostication.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Heart failure with supranormal ejection fraction, an unnoticed but emerging entity in HF, carries a similarly increased cardiovascular risk as HFrEF but has unique structural and plasma proteomic characteristics.</p>\n </section>\n </div>","PeriodicalId":164,"journal":{"name":"European Journal of Heart Failure","volume":"27 8","pages":"1570-1583"},"PeriodicalIF":10.8000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3654","citationCount":"0","resultStr":"{\"title\":\"Clinical and plasma proteomic characterization of heart failure with supranormal left ventricular ejection fraction: An emerging entity of heart failure\",\"authors\":\"Yasuhiko Sakata, Kotaro Nochioka, Satoshi Yasuda, Koichi Ishida, Takashi Shiroto, Jun Takahashi, Shintaro Kasahara, Ruri Abe, Shinsuke Yamanaka, Takahide Fujihashi, Hideka Hayashi, Shintaro Kato, Katsunori Horii, Kanako Teramoto, Tsutomu Tomita, Satoshi Miyata, Koichiro Sugimura, Iwao Waga, Masao Nagasaki, Hiroaki Shimokawa\",\"doi\":\"10.1002/ejhf.3654\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>The clinical guidelines categorize heart failure (HF) based on left ventricular ejection fraction (LVEF). However, the current LVEF cutoffs, 40% and 50%, may not fully address the underlying characteristics and cardiovascular risk of HF, particularly for HF with higher LVEF. This study aimed to characterize HF with supranormal ejection fraction (HFsnEF) using different LVEF cutoffs (35%, 55%, and 70% for men, and 40%, 60%, and 75% for women).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods and results</h3>\\n \\n <p>This study divided 442 patients from the CHART-Omics study into four groups: HF with reduced ejection fraction (HFrEF) (<i>n</i> = 55, 65.5 years), HF with mildly reduced ejection fraction (HFmrEF) (<i>n</i> = 125, 69.3 years), HF with normal ejection fraction (HFnEF) (<i>n</i> = 215, 69.0 years) and HFsnEF (<i>n</i> = 47, 67.1 years). When clinical backgrounds were adjusted and HFnEF served as the reference, HFsnEF carried an increased hazard ratio (HR) for the composite of cardiovascular death and HF hospitalization of 2.71 (95% confidence interval [CI] 1.10–6.66, <i>p</i> = 0.030), while HFrEF had a HR of 3.14 (95% CI 1.36–7.23, <i>p</i> = 0.007). HFsnEF was characterized by an increase in relative left ventricular wall thickness and a decrease in left ventricular dimensions, whereas increased left ventricular mass and dimensions characterized HFrEF. Quantitative analysis of 4670 plasma proteins showed essential differences between HFsnEF and HFrEF, for example, ‘protein synthesis’ versus ‘cell morphology’, ‘cellular assembly and organization’ and ‘nucleic acid metabolism’ for underlying pathophysiology, and ‘energy production’ versus ‘connective tissue disorders’ and ‘cell-to-cell signalling and interaction’ for prognostication.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Heart failure with supranormal ejection fraction, an unnoticed but emerging entity in HF, carries a similarly increased cardiovascular risk as HFrEF but has unique structural and plasma proteomic characteristics.</p>\\n </section>\\n </div>\",\"PeriodicalId\":164,\"journal\":{\"name\":\"European Journal of Heart Failure\",\"volume\":\"27 8\",\"pages\":\"1570-1583\"},\"PeriodicalIF\":10.8000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.3654\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ejhf.3654\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ejhf.3654","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Clinical and plasma proteomic characterization of heart failure with supranormal left ventricular ejection fraction: An emerging entity of heart failure
Aims
The clinical guidelines categorize heart failure (HF) based on left ventricular ejection fraction (LVEF). However, the current LVEF cutoffs, 40% and 50%, may not fully address the underlying characteristics and cardiovascular risk of HF, particularly for HF with higher LVEF. This study aimed to characterize HF with supranormal ejection fraction (HFsnEF) using different LVEF cutoffs (35%, 55%, and 70% for men, and 40%, 60%, and 75% for women).
Methods and results
This study divided 442 patients from the CHART-Omics study into four groups: HF with reduced ejection fraction (HFrEF) (n = 55, 65.5 years), HF with mildly reduced ejection fraction (HFmrEF) (n = 125, 69.3 years), HF with normal ejection fraction (HFnEF) (n = 215, 69.0 years) and HFsnEF (n = 47, 67.1 years). When clinical backgrounds were adjusted and HFnEF served as the reference, HFsnEF carried an increased hazard ratio (HR) for the composite of cardiovascular death and HF hospitalization of 2.71 (95% confidence interval [CI] 1.10–6.66, p = 0.030), while HFrEF had a HR of 3.14 (95% CI 1.36–7.23, p = 0.007). HFsnEF was characterized by an increase in relative left ventricular wall thickness and a decrease in left ventricular dimensions, whereas increased left ventricular mass and dimensions characterized HFrEF. Quantitative analysis of 4670 plasma proteins showed essential differences between HFsnEF and HFrEF, for example, ‘protein synthesis’ versus ‘cell morphology’, ‘cellular assembly and organization’ and ‘nucleic acid metabolism’ for underlying pathophysiology, and ‘energy production’ versus ‘connective tissue disorders’ and ‘cell-to-cell signalling and interaction’ for prognostication.
Conclusions
Heart failure with supranormal ejection fraction, an unnoticed but emerging entity in HF, carries a similarly increased cardiovascular risk as HFrEF but has unique structural and plasma proteomic characteristics.
期刊介绍：
European Journal of Heart Failure is an international journal dedicated to advancing knowledge in the field of heart failure management. The journal publishes reviews and editorials aimed at improving understanding, prevention, investigation, and treatment of heart failure. It covers various disciplines such as molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, clinical sciences, social sciences, and population sciences. The journal welcomes submissions of manuscripts on basic, clinical, and population sciences, as well as original contributions on nursing, care of the elderly, primary care, health economics, and other related specialist fields. It is published monthly and has a readership that includes cardiologists, emergency room physicians, intensivists, internists, general physicians, cardiac nurses, diabetologists, epidemiologists, basic scientists focusing on cardiovascular research, and those working in rehabilitation. The journal is abstracted and indexed in various databases such as Academic Search, Embase, MEDLINE/PubMed, and Science Citation Index.
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