Using cardiac magnetic resonance imaging technology, the ejection fraction of heart failure (HFpEF) and different subtypes of cardiac magnetic resonance characteristics, and combined with the clinical characteristics and prognosis of the patient, explore the value of cardiac magnetic resonance in disease diagnosis, classification, treatment and prognosis, and provide new ideas for clinical practice.
1. Study Objectives To compare clinical characteristics among HFpEF patients with different comorbidity subtypes (hypertension, type 2 diabetes, renal insufficiency, obesity). To identify distinct cardiac magnetic resonance (CMR) features associated with HFpEF and its comorbidity subtypes. To evaluate prognostic differences (mortality, heart failure readmission, healthcare costs) across HFpEF subtypes. 2. Study Design Type: Single-center, prospective, observational cohort study. Duration: April 1, 2023 - December 31, 2026. Sample Size: 500 HFpEF patients, with \~200 patients per subgroup. 3. Data Collection Framework Baseline Data: Clinical Parameters: Demographics (age, gender, BMI). Comorbidities (hypertension, diabetes, renal function). Biochemical markers (BNP/NT-proBNP, HbA1c, lipid profile, renal function). Medications (ACE inhibitors, beta-blockers, diuretics). Imaging Data: Echocardiography: Left ventricular ejection fraction (LVEF ≥50%). CMR: Ventricular volumes, mass, strain analysis, T1 mapping, and late gadolinium enhancement (LGE). Follow-Up Protocol: Frequency: Every 6 months post-discharge. Endpoints: Primary: Cardiovascular mortality, HF-related readmission. Secondary: Changes in CMR parameters, medication adjustments, healthcare utilization. 4. Subgroup Classification Comorbidity Subgroups: HFpEF + Hypertension. HFpEF + Type 2 Diabetes. HFpEF + Renal Insufficiency. HFpEF + Obesity. Control Group: HFpEF patients without the above comorbidities. 5. CMR Protocol Imaging Sequences: Cine imaging for ventricular function. T1 mapping for myocardial fibrosis assessment. LGE for scar detection. Post-Processing: Analysis of myocardial strain, extracellular volume (ECV), and perfusion reserve. 6. Statistical Analysis Methods: Regression analysis for associations between CMR features and clinical outcomes. Survival analysis (Kaplan-Meier, Cox proportional hazards models). Subgroup comparisons using ANOVA or non-parametric tests. Software: SPSS 20.0 (significance threshold: p \<0.05). 7. Ethical and Data Management Privacy Protection: De-identified data storage with restricted access. Data Validation: Double-entry verification for 10% of randomly selected cases. Compliance: Adherence to institutional review board (IRB) guidelines and GCP standards.
Study Type
This study included patients who were diagnosed with HFpEF and had completed CMR.
the Affiliated Hospital of Xuzhou Medical University
Xuzhou, Jiangsu, China
Rate of Cardiovascular death
Time frame: follow - up every 6 months; up to 24 - months
Rate of readmission of heart failure
Time frame: follow - up every 6 months; up to 24 - months
Body Temperature
Measure body temperature every morning on an empty stomach using an electronic thermometer, with the unit being degrees Celsius (℃)
Time frame: Baseline
Blood Glucose Levels
Draw blood on an empty stomach in the morning and detect fasting blood glucose using a biochemical analyzer, with the unit being mmol/L; measure 2 - hour post - prandial blood glucose using a portable blood glucose meter, with the unit being mmol/L.
Time frame: Baseline
Brain Natriuretic Peptide (BNP)
Detect BNP levels using an electrochemiluminescence immunoassay analyzer, with the unit being picograms per milliliter (pg/mL).
Time frame: Baseline
Glycated Hemoglobin (HbA1c)
Detect glycated hemoglobin using high - performance liquid chromatography, and the result is expressed as a percentage (%).
Time frame: Baseline
Blood Pressure
Measure blood pressure once in the morning and once in the evening every day using a blood pressure monitor, with the unit being millimeters of mercury (mmHg)
Time frame: Baseline
Heart Rate
Continuously monitor the heart rate using an electrocardiogram monitor, with the unit being beats per minute (bpm).
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OBSERVATIONAL
Enrollment
500
Time frame: Baseline