Table 2.
Heart failure phenotypes identified in machine learning models
| Study and population | Group 1 | Group 2 | Group 3 | Group 4 | Group 5 | Group 6 | |
|---|---|---|---|---|---|---|---|
| HF phenogroups and clinical outcomes | |||||||
| ȃShah et al. 201425 ȃHFpEF |
Characteristics | Younger, least electrical and myocardial remodelling, lower BNP. | Higher prevalence of obesity, diabetes, OSA with worst LV relaxation, highest PCWP, highest PVR. | Oldest, with worst electrical (wide QRS) and myocardial remodelling (thickest LV, worst RV function), more CKD, highest BNP. | — | — | — |
| Outcomes | Lower risk of CV death, HF hospitalization, or all-cause death. | Intermediate risk of CV death, HF hospitalization, or all-cause death. | Highest risk of CV death, HF hospitalization, or all-cause death. | — | — | — | |
| ȃGevaert et al. 202127 ȃHFrEF, HFmEF, HfpEF |
Characteristics | Coronary artery disease as the predominant comorbidity. | Valvular heart disease as the predominant comorbidity. | Fewest comorbidities (hypertension and diabetes). | Atrial fibrillation as the predominant comorbidity. | COPD as the predominant comorbidity. | OSA as the predominant comorbidity. |
| Outcomes | Fourth highest risk of composite all-cause death or hospitalization at 12 months. | Second highest risk of composite all-cause death or hospitalization at 12 months. | Lowest risk of composite all-cause death or hospitalization at 12 months. | Fifth highest risk of composite all-cause death or hospitalization at 12 months. | Highest risk of composite all-cause death or hospitalization at 12 months | Third highest risk of composite all-cause death or hospitalization at 12 month. | |
| ȃBose et al. 201828 ȃHFrEF, HFmEF, HFpEF patients enrolled in a home telehealth programme |
Characteristics | Younger patients, with the lowest proportion of CAD, greatest number of comorbidities, highest number of prescribed medications. | Oldest patients, primary women, lowest proportion of CKD, diabetes, fewest comorbidities. | Older patients, highest proportion with CAD, CKD, lowest number of prescribed medications. | — | — | — |
| Outcomes | Longest home health length of stay, most hospitalizations. | Lower than average home health length of stay, similar hospitalizations to overall cohort. | Shortest home health length of stay, fewest hospitalizations. | — | — | — | |
| HF phenogroups and response to device therapy | |||||||
| ȃCikes et al. 2019.29 ȃHFrEF patients with CRT-D |
Characteristics | Non-ischaemic cardiomyopathy, LBBB, longest QRS, youngest, high proportion female, most remodelled LA, LV, RV, lowest LVEF. | Ischaemic cardiomyopathy, low proportion of LBBB, largest proportion male, hypertension, diabetes, least remodelled LA, LV, high LVEF. | Non-ischaemic cardiomyopathy, LBBB, highest proportion female, less remodelled LA, LV, high LVEF | Ischaemic cardiomyopathy, low proportion LBBB, high proportion male, HTN, diabetes, remodelled LV, RV, low LVEF, extensive apical scar. | — | — |
| Outcomes | CRT-D responders. | CRT-D non-responders. | CRT-D responders. | CRT-D non-responders. | — | — | |
| HF phenogroups and response to pharmacotherapy | |||||||
| ȃAhmad et al. 201830 ȃHFrEF, HFmEF, HFpEF |
Characteristics | Oldest, largest proportion female, largest proportion HFpEF, highest BP, highest proportion non-ischaemic, highest BNP, lowest use of BB and ACEi. | Younger age, mainly male, highest BMI, greatest prevalence of diabetes, hypertension, dyslipidaemia, high proportion of HFrEF, ischaemic cardiomyopathy, lowest BNP. | Older age, lower prevalence of HFpEF, lowest BMI, most comorbidities including OSA, CKD, atrial fibrillation, COPD, high proportion of ischaemic cardiomyopathy, highest NT-proBNP, low use of BB, ACEi. | Youngest, mainly male, high BMI, highest proportion of HFrEF, highest proportion of ischaemic cardiomyopathy, fewest comorbidities, low BNP. | — | — |
| Outcomes | Derived the least benefit from BB. Moderate 1-year survival. | Derived the greatest benefit from ARB. Highest 1-year survival. | Derived the greatest benefit from BB, benefited from nitrate therapy. Lowest 1-year survival. | Derived the greatest benefit from BB, worst outcomes among patients on diuretics, worst outcomes on nitrates. High 1-year survival. | — | — | |
ACEi, ACE inhibitor; BB, beta-blocker; BNP, brain-derived natriuretic peptide; CAD, coronary artery disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CRT-D, cardiac resynchronization therapy-defibrillator; CV, cardiovascular; HFmEF, heart failure with mid-range ejection fraction; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; LA, left atrium; LV, left ventricle; LVEF, left ventricular ejection fraction; NT-proBNP, N-terminal prohormone of brain-derived natriuretic hormone; OSA, obstructive sleep apnoea; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; RV, right ventricle. Cells marked with a "—" indicate that there was a limited number of phenogroups (<6).