HeartShare: Combining Omics, Deep Phenotyping, and Electronic Health Records for Heart Failure Subtypes and Treatment Targets

Eligibility Criteria

• 1. Age ≥30 years.
• 2. Prior diagnosis of HF in the EHR (any left ventricular ejection fraction).
• 1. Age ≥30 years.
• 2. No known prior diagnosis of HF or use of loop diuretics.
• 3. No known prior history of BNP \>100 pg/ml or NTproBNP \>300 pg/ml, if prior laboratory tests are available in the EHR.
• 1. Age ≥30 years.
• 2. Left ventricular ejection fraction ≥50% measured by echocardiography.
• 3. Definition of HFpEF: signs and symptoms of HF, NYHA functional class II-IV, and at least one of the following:
• 1. Elevated BNP (≥75 pg/ml in sinus rhythm or ≥225 pg/ml in atrial fibrillation/flutter) or NTproBNP (≥225 pg/ml in sinus rhythm or ≥675 in atrial fibrillation/flutter) at baseline. Choice of BNP or NTproBNP is based on availability at each clinical center.
• 2. Prior HF hospitalization (primary reason for the hospitalization is HF with elevated natriuretic peptide levels \[using the thresholds listed above\], requiring IV diuresis for HF, or pulmonary edema or pulmonary vascular congestion on chest radiography).
• 3. Elevated pulmonary capillary wedge pressure (PCWP) at rest (≥15 mmHg) or during exercise (≥25 mmHg for supine exercise or PCWP/cardiac output ratio ≥2 mmHg/L/min for upright exercise).
• 4. Elevated H2FPEF score26 (≥5) or HFA-PEFF27 score (≥5).
• 1. Age ≥30 years.
• 2. Left ventricular ejection fraction ≥50% measured by echocardiography.
• 3. No known prior diagnosis of HF or use of diuretics for fluid management.
• 4. No known prior history of BNP ≥75 pg/ml or NTproBNP ≥225 pg/ml, if prior laboratory tests are available in the EHR.
• 5. BNP \<75 pg/ml or NTproBNP \<225 pg/ml at the time of screening. Choice of BNP or NTproBNP is based on availability at each clinical center.
• 1. For non-HF group: any prior known left ventricular ejection fraction \<50%.
• 2. Prior history of solid organ transplantation.
• 3. Prior history of mechanical circulatory support.
• 4. Prior history of non-cardiac cirrhosis.
• 5. Inability to provide written consent to the study.
• 1. Life expectancy estimated to be \< 1 year.
• 2. Primary cardiomyopathy (including amyloid, hypertrophic cardiomyopathy, cardiac sarcoidosis, hemochromatosis, or other infiltrative cardiomyopathies) or pulmonary arterial hypertension (WHO Group I, III, or IV pulmonary hypertension).
• 3. Any prior known left ventricular ejection fraction \<40%, except if this occurred only in the setting of an acute tachycardia episode (e.g., acute atrial fibrillation).
• 4. Clinically significant valvular heart disease defined as:
• 1. Moderate to greater aortic stenosis, pulmonic stenosis, or tricuspid stenosis.
• 2. Any mitral stenosis.
• 3. Moderate or greater aortic regurgitation.
• 4. Greater than moderate mitral regurgitation.
• 5. Any planned cardiac surgery or cardiac intervention in the next 3 months.
• 6. Alternative primary reason for symptoms of shortness of breath and exercise intolerance in HFpEF participants in the opinion of the enrolling investigator.
• 7. Cardiac surgery, acute coronary syndrome, percutaneous coronary intervention, stroke, transient ischemic attack, or carotid intervention in the preceding 6 months prior to enrollment.
• 8. Known symptomatic epicardial coronary artery disease that is not revascularized.
• 9. Any non-elective hospitalization in the preceding 2 weeks.
• 10. Prior history of solid organ transplantation.
• 11. Prior history of chronic infection (HIV, hepatitis C, hepatitis B, tuberculosis) unless treated and not clinically active in the opinion of the enrolling investigator.
• 12. Prior history of mechanical circulatory support.
• 13. Prior history of non-cardiac cirrhosis.
• 14. Estimated GFR \<20 ml/min/1.73m2 or currently on dialysis.
• 15. Any condition that may preclude participation or adherence to the study protocol, in the opinion of the enrolling investigator.
• 16. Inability to provide written consent to the study.
• 17. Current acute decompensated heart failure.
• 18. Currently pregnant.