Heart failure & cardiomyopathiesCohort study

Characterizing the heterogeneity of heart failure with preserved ejection fraction: moving beyond subgroups and distinguishing disease from risk

Eur J Heart FailPublished

  • Prospective cohort study
  • deeply phenotyped, multi-modal cohort
  • external validation in UK Biobank
  • sensitivity analyses

Authors' conclusion

HFpEF risk and disease course reflect a variable interplay of pathophysiological processes in each individual.

Study context

Population
Patients with HF and LVEF ≥ 50% (heart failure with preserved ejection fraction (HFpEF))
Participants
902 patients

Main finding

As reported in the abstract

HFpEF phenotypic heterogeneity (clustering and DDRTree tree structure)
  • Conventional clustering did not identify meaningful subgroups
  • DDRTree revealed a stable, interpretable tree structure capturing continuous variation in cardiac structure and function, biomarkers and comorbidities

Observational data: associations, not effects.

Further findings

HFpEF vs comorbidity-matched controls (n=902)

A profile of cardiac and systemic characteristics distinguishing HFpEF from its associated comorbidities was identified

Original publication

Characterizing the heterogeneity of heart failure with preserved ejection fraction: moving beyond subgroups and distinguishing disease from risk. Eur J Heart Fail. Published 5 March 2026. doi:10.1093/ejhf/xuag056

Summarised from the published abstract; every number is checked against it