Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design

Danish Ali; Nualla Callan; Stuart Ennis; Richard Powell; Scott McGuire; Gordon McGregor; Martin O Weickert; Michelle A Miller; Francesco P Cappuccio; Prithwish Banerjee

doi:10.1136/bmjopen-2018-027984

Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design

Danish Ali, Nualla Callan, Stuart Ennis, Richard Powell, Scott McGuire, Gordon McGregor, Martin O Weickert, Michelle A Miller, Francesco P Cappuccio, Prithwish Banerjee

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

107 Downloads (Pure)

Abstract

AIMS: There has been a paradigm shift proposing that comorbidities are a major contributor towards the heart failure with preserved ejection fraction (HFpEF) syndrome. Furthermore, HFpEF patients have abnormal macrovascular and microvascular function, which may significantly contribute towards altered ventricular-vascular coupling in these patients. The IDENTIFY-HF study will investigate whether gradually increased arterial stiffness (in addition to ageing) as a result of increasing common comorbidities, such as hypertension and diabetes, is associated with HFpEF.

METHODS AND ANALYSIS: In our observational study, arterial compliance and microvascular function will be assessed in five groups (Groups A to E) of age, sex and body mass index matched subjects (age ≥70 years in all groups):Group A; normal healthy volunteers without major comorbidities such as hypertension and diabetes mellitus (control). Group B; patients with hypertension without diabetes mellitus or heart failure (HF). Group C; patients with hypertension and diabetes mellitus without HF. Group D; patients with HFpEF. Group E; patients with heart failure and reduced ejection fraction (parallel group). Vascular function and arterial compliance will be assessed using pulse wave velocity, as the primary outcome measure. Further outcome measures include cutaneous laser Doppler flowmetry as a measure of endothelial function, transthoracic echocardiography and exercise tolerance measures. Biomarkers include NT-proBNP, high-sensitivity troponin T, as well as serum galectin-3 as a marker of fibrosis.

ETHICS AND DISSEMINATION: The study was approved by the regional research ethics committee (REC), West Midland and Black Country 17/WM/0039, UK, and permission to conduct the study in the hospital was also obtained from the RDI, UHCW NHS Trust. The results will be published in peer-reviewed journals and presented in local, national and international medical society meetings.

TRIAL REGISTRATION NUMBER: NCT03186833.

Original language	English
Article number	027984
Pages (from-to)	e027984
Journal	BMJ Open
Volume	9
Issue number	11
DOIs	https://doi.org/10.1136/bmjopen-2018-027984
Publication status	Published - 19 Nov 2019
Externally published	Yes

Bibliographical note

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.

Keywords

arterial stiffness
comorbidities
heart failure with preserved ejection fraction
pathophysiology

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/bmjopen-2018-027984

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Ali, D., Callan, N., Ennis, S., Powell, R., McGuire, S., McGregor, G., Weickert, M. O., Miller, M. A., Cappuccio, F. P., & Banerjee, P. (2019). Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design. BMJ Open, 9(11), e027984. Article 027984. https://doi.org/10.1136/bmjopen-2018-027984

Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design. / Ali, Danish; Callan, Nualla; Ennis, Stuart et al.
In: BMJ Open, Vol. 9, No. 11, 027984, 19.11.2019, p. e027984.

Research output: Contribution to journal › Article › peer-review

Ali, D, Callan, N, Ennis, S, Powell, R, McGuire, S, McGregor, G, Weickert, MO, Miller, MA, Cappuccio, FP & Banerjee, P 2019, 'Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design', BMJ Open, vol. 9, no. 11, 027984, pp. e027984. https://doi.org/10.1136/bmjopen-2018-027984

Ali D, Callan N, Ennis S, Powell R, McGuire S, McGregor G et al. Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design. BMJ Open. 2019 Nov 19;9(11):e027984. 027984. doi: 10.1136/bmjopen-2018-027984

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abstract = "AIMS: There has been a paradigm shift proposing that comorbidities are a major contributor towards the heart failure with preserved ejection fraction (HFpEF) syndrome. Furthermore, HFpEF patients have abnormal macrovascular and microvascular function, which may significantly contribute towards altered ventricular-vascular coupling in these patients. The IDENTIFY-HF study will investigate whether gradually increased arterial stiffness (in addition to ageing) as a result of increasing common comorbidities, such as hypertension and diabetes, is associated with HFpEF.METHODS AND ANALYSIS: In our observational study, arterial compliance and microvascular function will be assessed in five groups (Groups A to E) of age, sex and body mass index matched subjects (age ≥70 years in all groups):Group A; normal healthy volunteers without major comorbidities such as hypertension and diabetes mellitus (control). Group B; patients with hypertension without diabetes mellitus or heart failure (HF). Group C; patients with hypertension and diabetes mellitus without HF. Group D; patients with HFpEF. Group E; patients with heart failure and reduced ejection fraction (parallel group). Vascular function and arterial compliance will be assessed using pulse wave velocity, as the primary outcome measure. Further outcome measures include cutaneous laser Doppler flowmetry as a measure of endothelial function, transthoracic echocardiography and exercise tolerance measures. Biomarkers include NT-proBNP, high-sensitivity troponin T, as well as serum galectin-3 as a marker of fibrosis.ETHICS AND DISSEMINATION: The study was approved by the regional research ethics committee (REC), West Midland and Black Country 17/WM/0039, UK, and permission to conduct the study in the hospital was also obtained from the RDI, UHCW NHS Trust. The results will be published in peer-reviewed journals and presented in local, national and international medical society meetings.TRIAL REGISTRATION NUMBER: NCT03186833.",

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AU - Callan, Nualla

AU - Ennis, Stuart

AU - Powell, Richard

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AU - McGregor, Gordon

AU - Weickert, Martin O

AU - Miller, Michelle A

AU - Cappuccio, Francesco P

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Heart failure with preserved ejection fraction (HFpEF) pathophysiology study (IDENTIFY-HF): does increased arterial stiffness associate with HFpEF, in addition to ageing and vascular effects of comorbidities? Rationale and design

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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