Skip to main content
Erschienen in: Journal of Cardiovascular Translational Research 3/2017

03.03.2017 | Original Article

Phenomapping for the Identification of Hypertensive Patients with the Myocardial Substrate for Heart Failure with Preserved Ejection Fraction

verfasst von: Daniel H. Katz, Rahul C. Deo, Frank G. Aguilar, Senthil Selvaraj, Eva E. Martinez, Lauren Beussink-Nelson, Kwang-Youn A. Kim, Jie Peng, Marguerite R. Irvin, Hemant Tiwari, D. C. Rao, Donna K. Arnett, Sanjiv J. Shah

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

We sought to evaluate whether unbiased machine learning of dense phenotypic data (“phenomapping”) could identify distinct hypertension subgroups that are associated with the myocardial substrate (i.e., abnormal cardiac mechanics) for heart failure with preserved ejection fraction (HFpEF). In the HyperGEN study, a population- and family-based study of hypertension, we studied 1273 hypertensive patients utilizing clinical, laboratory, and conventional echocardiographic phenotyping of the study participants. We used machine learning analysis of 47 continuous phenotypic variables to identify mutually exclusive groups constituting a novel classification of hypertension. The phenomapping analysis classified study participants into 2 distinct groups that differed markedly in clinical characteristics, cardiac structure/function, and indices of cardiac mechanics (e.g., phenogroup #2 had a decreased absolute longitudinal strain [12.8 ± 4.1 vs. 14.6 ± 3.5%] even after adjustment for traditional comorbidities [p < 0.001]). The 2 hypertension phenogroups may represent distinct subtypes that may benefit from targeted therapies for the prevention of HFpEF.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Oktay, A. A., & Shah, S. J. (2014). Current perspectives on systemic hypertension in heart failure with preserved ejection fraction. Current Cardiology Reports, 16(12), 545.CrossRefPubMed Oktay, A. A., & Shah, S. J. (2014). Current perspectives on systemic hypertension in heart failure with preserved ejection fraction. Current Cardiology Reports, 16(12), 545.CrossRefPubMed
2.
Zurück zum Zitat Egan, B. M., Zhao, Y., & Axon, R. N. (2010). US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA, 303(20), 2043–2050.CrossRefPubMed Egan, B. M., Zhao, Y., & Axon, R. N. (2010). US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA, 303(20), 2043–2050.CrossRefPubMed
3.
Zurück zum Zitat Citterio, L., Lanzani, C., & Manunta, P. (2011). Polymorphisms, hypertension and thiazide diuretics. Pharmacogenomics, 12(11), 1587–1604.CrossRefPubMed Citterio, L., Lanzani, C., & Manunta, P. (2011). Polymorphisms, hypertension and thiazide diuretics. Pharmacogenomics, 12(11), 1587–1604.CrossRefPubMed
4.
Zurück zum Zitat Cuspidi, C., Rescaldani, M., Sala, C., Negri, F., Grassi, G., & Mancia, G. (2012). Prevalence of electrocardiographic left ventricular hypertrophy in human hypertension: an updated review. Journal of Hypertension, 30(11), 2066–2073.CrossRefPubMed Cuspidi, C., Rescaldani, M., Sala, C., Negri, F., Grassi, G., & Mancia, G. (2012). Prevalence of electrocardiographic left ventricular hypertrophy in human hypertension: an updated review. Journal of Hypertension, 30(11), 2066–2073.CrossRefPubMed
5.
Zurück zum Zitat Cuspidi, C., Sala, C., Negri, F., Mancia, G., Morganti, A., & Italian Society of H. (2012). Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. Journal of Human Hypertension, 26(6), 343–349. Cuspidi, C., Sala, C., Negri, F., Mancia, G., Morganti, A., & Italian Society of H. (2012). Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies. Journal of Human Hypertension, 26(6), 343–349.
6.
Zurück zum Zitat Dahlof, B., Devereux, R. B., Kjeldsen, S. E., Julius, S., Beevers, G., de Faire, U., et al. (2002). Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet, 359(9311), 995–1003.CrossRefPubMed Dahlof, B., Devereux, R. B., Kjeldsen, S. E., Julius, S., Beevers, G., de Faire, U., et al. (2002). Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet, 359(9311), 995–1003.CrossRefPubMed
7.
Zurück zum Zitat Sagie, A., Larson, M. G., & Levy, D. (1993). The natural history of borderline isolated systolic hypertension. The New England Journal of Medicine, 329(26), 1912–1917.CrossRefPubMed Sagie, A., Larson, M. G., & Levy, D. (1993). The natural history of borderline isolated systolic hypertension. The New England Journal of Medicine, 329(26), 1912–1917.CrossRefPubMed
8.
Zurück zum Zitat Suonsyrja, T., Hannila-Handelberg, T., Paavonen, K. J., Miettinen, H. E., Donner, K., Strandberg, T., et al. (2008). Laboratory tests as predictors of the antihypertensive effects of amlodipine, bisoprolol, hydrochlorothiazide and losartan in men: results from the randomized, double-blind, crossover GENRES Study. Journal of Hypertension, 26(6), 1250–1256.CrossRefPubMed Suonsyrja, T., Hannila-Handelberg, T., Paavonen, K. J., Miettinen, H. E., Donner, K., Strandberg, T., et al. (2008). Laboratory tests as predictors of the antihypertensive effects of amlodipine, bisoprolol, hydrochlorothiazide and losartan in men: results from the randomized, double-blind, crossover GENRES Study. Journal of Hypertension, 26(6), 1250–1256.CrossRefPubMed
9.
Zurück zum Zitat Perneger, T. V. (1993). Projections of hypertension-related renal disease in middle-aged residents of the United States. JAMA, 269(10), 1272.CrossRefPubMed Perneger, T. V. (1993). Projections of hypertension-related renal disease in middle-aged residents of the United States. JAMA, 269(10), 1272.CrossRefPubMed
10.
Zurück zum Zitat Andreadis, E. A., Tsourous, G. I., Tzavara, C. K., Georgiopoulos, D. X., Katsanou, P. M., Marakomichelakis, G. E., et al. (2007). Metabolic syndrome and incident cardiovascular morbidity and mortality in a Mediterranean hypertensive population. American Journal of Hypertension, 20(5), 558–564.CrossRefPubMed Andreadis, E. A., Tsourous, G. I., Tzavara, C. K., Georgiopoulos, D. X., Katsanou, P. M., Marakomichelakis, G. E., et al. (2007). Metabolic syndrome and incident cardiovascular morbidity and mortality in a Mediterranean hypertensive population. American Journal of Hypertension, 20(5), 558–564.CrossRefPubMed
11.
Zurück zum Zitat Ceravolo, R., Maio, R., Cuda, G., Scozzafava, A., Sciacqua, A., Vatrano, M., et al. (2003). Relation of fasting insulin related to insertion/deletion polymorphism of angiotensin-converting enzyme-gene and cardiac mass in never-treated patients with systemic hypertension. American Journal of Cardiology, 92(10), 1234–1237.CrossRefPubMed Ceravolo, R., Maio, R., Cuda, G., Scozzafava, A., Sciacqua, A., Vatrano, M., et al. (2003). Relation of fasting insulin related to insertion/deletion polymorphism of angiotensin-converting enzyme-gene and cardiac mass in never-treated patients with systemic hypertension. American Journal of Cardiology, 92(10), 1234–1237.CrossRefPubMed
12.
Zurück zum Zitat Conen, D., Zeller, A., Pfisterer, M., & Martina, B. (2006). Usefulness of B-type natriuretic peptide and C-reactive protein in predicting the presence or absence of left ventricular hypertrophy in patients with systemic hypertension. American Journal of Cardiology, 97(2), 249–252.CrossRefPubMed Conen, D., Zeller, A., Pfisterer, M., & Martina, B. (2006). Usefulness of B-type natriuretic peptide and C-reactive protein in predicting the presence or absence of left ventricular hypertrophy in patients with systemic hypertension. American Journal of Cardiology, 97(2), 249–252.CrossRefPubMed
13.
Zurück zum Zitat Greenberg, J. (2006). Are blood pressure predictors of cardiovascular disease mortality different for prehypertensives than for hypertensives? American Journal of Hypertension, 19(5), 454–461.CrossRefPubMed Greenberg, J. (2006). Are blood pressure predictors of cardiovascular disease mortality different for prehypertensives than for hypertensives? American Journal of Hypertension, 19(5), 454–461.CrossRefPubMed
14.
Zurück zum Zitat Hiltunen, T. P., & Kontula, K. (2012). Clinical and molecular approaches to individualize antihypertensive drug therapy. Annals of Medicine, 44(Suppl 1), S23–S29.CrossRefPubMed Hiltunen, T. P., & Kontula, K. (2012). Clinical and molecular approaches to individualize antihypertensive drug therapy. Annals of Medicine, 44(Suppl 1), S23–S29.CrossRefPubMed
15.
Zurück zum Zitat Hiltunen, T. P., Suonsyrja, T., Hannila-Handelberg, T., Paavonen, K. J., Miettinen, H. E., Strandberg, T., et al. (2007). Predictors of antihypertensive drug responses: initial data from a placebo-controlled, randomized, cross-over study with four antihypertensive drugs (The GENRES Study). American Journal of Hypertension, 20(3), 311–318.CrossRefPubMed Hiltunen, T. P., Suonsyrja, T., Hannila-Handelberg, T., Paavonen, K. J., Miettinen, H. E., Strandberg, T., et al. (2007). Predictors of antihypertensive drug responses: initial data from a placebo-controlled, randomized, cross-over study with four antihypertensive drugs (The GENRES Study). American Journal of Hypertension, 20(3), 311–318.CrossRefPubMed
16.
Zurück zum Zitat Matsui, Y., Eguchi, K., Shibasaki, S., Ishikawa, J., Shimada, K., & Kario, K. (2010). Morning hypertension assessed by home monitoring is a strong predictor of concentric left ventricular hypertrophy in patients with untreated hypertension. Journal of Clinical Hypertension (Greenwich, Conn.), 12(10), 776–783.CrossRef Matsui, Y., Eguchi, K., Shibasaki, S., Ishikawa, J., Shimada, K., & Kario, K. (2010). Morning hypertension assessed by home monitoring is a strong predictor of concentric left ventricular hypertrophy in patients with untreated hypertension. Journal of Clinical Hypertension (Greenwich, Conn.), 12(10), 776–783.CrossRef
17.
Zurück zum Zitat Nakamura, M., Tanaka, F., Yonezawa, S., Satou, K., Nagano, M., & Hiramori, K. (2003). The limited value of plasma B-type natriuretic peptide for screening for left ventricular hypertrophy among hypertensive patients. American Journal of Hypertension, 16(12), 1025–1029.CrossRefPubMed Nakamura, M., Tanaka, F., Yonezawa, S., Satou, K., Nagano, M., & Hiramori, K. (2003). The limited value of plasma B-type natriuretic peptide for screening for left ventricular hypertrophy among hypertensive patients. American Journal of Hypertension, 16(12), 1025–1029.CrossRefPubMed
18.
Zurück zum Zitat Perez-Lloret, S., Toblli, J. E., Cardinali, D. P., Malateste, J. C., & Milei, J. (2008). Nocturnal hypertension defined by fixed cut-off limits is a better predictor of left ventricular hypertrophy than non-dipping. International Journal of Cardiology, 127(3), 387–389.CrossRefPubMed Perez-Lloret, S., Toblli, J. E., Cardinali, D. P., Malateste, J. C., & Milei, J. (2008). Nocturnal hypertension defined by fixed cut-off limits is a better predictor of left ventricular hypertrophy than non-dipping. International Journal of Cardiology, 127(3), 387–389.CrossRefPubMed
19.
Zurück zum Zitat Phillips, R. A. (1998). Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects. Journal of Clinical Endocrinology & Metabolism, 83(12), 4284–4288. Phillips, R. A. (1998). Relation among left ventricular mass, insulin resistance, and blood pressure in nonobese subjects. Journal of Clinical Endocrinology & Metabolism, 83(12), 4284–4288.
20.
Zurück zum Zitat Schillaci, G., Pirro, M., Vaudo, G., Gemelli, F., Marchesi, S., Porcellati, C., et al. (2004). Prognostic value of the metabolic syndrome in essential hypertension. Journal of the American College of Cardiology, 43(10), 1817–1822.CrossRefPubMed Schillaci, G., Pirro, M., Vaudo, G., Gemelli, F., Marchesi, S., Porcellati, C., et al. (2004). Prognostic value of the metabolic syndrome in essential hypertension. Journal of the American College of Cardiology, 43(10), 1817–1822.CrossRefPubMed
21.
Zurück zum Zitat Vasan, R. S., Benjamin, E. J., Larson, M. G., Leip, E. P., Wang, T. J., Wilson, P. W., et al. (2002). Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham Heart Study. JAMA, 288(10), 1252–1259.CrossRefPubMed Vasan, R. S., Benjamin, E. J., Larson, M. G., Leip, E. P., Wang, T. J., Wilson, P. W., et al. (2002). Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham Heart Study. JAMA, 288(10), 1252–1259.CrossRefPubMed
22.
Zurück zum Zitat International Consortium for Blood Pressure Genome-Wide Association, S, Ehret, G. B., Munroe, P. B., Rice, K. M., Bochud, M., Johnson, A. D., et al. (2011). Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Nature, 478(7367), 103–109.CrossRef International Consortium for Blood Pressure Genome-Wide Association, S, Ehret, G. B., Munroe, P. B., Rice, K. M., Bochud, M., Johnson, A. D., et al. (2011). Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Nature, 478(7367), 103–109.CrossRef
23.
Zurück zum Zitat James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311(5), 507–520.CrossRefPubMed James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311(5), 507–520.CrossRefPubMed
24.
Zurück zum Zitat Shah, S. J., Katz, D. H., Selvaraj, S., Burke, M. A., Yancy, C. W., Georghiade, M., et al. (2015). Phenomapping for Novel classification of heart failure with preserved ejection fraction. Circulation, 131(3), 269–279.CrossRefPubMed Shah, S. J., Katz, D. H., Selvaraj, S., Burke, M. A., Yancy, C. W., Georghiade, M., et al. (2015). Phenomapping for Novel classification of heart failure with preserved ejection fraction. Circulation, 131(3), 269–279.CrossRefPubMed
25.
Zurück zum Zitat Kao, D. P., Stevens, L. M., Hinterberg, M. A., & Gorg, C. (2017). Phenotype-specific association of single-nucleotide polymorphisms with heart failure and preserved ejection fraction: a genome-wide association analysis of the cardiovascular health study. Journal of Cardiovascular Translational Research. Epub ahead of print. Kao, D. P., Stevens, L. M., Hinterberg, M. A., & Gorg, C. (2017). Phenotype-specific association of single-nucleotide polymorphisms with heart failure and preserved ejection fraction: a genome-wide association analysis of the cardiovascular health study. Journal of Cardiovascular Translational Research. Epub ahead of print.
26.
Zurück zum Zitat Luo, Y., Ahmad, F. S., & Shah, S. J. (2017). Tensor factorization for precision medicine in heart failure with preserved ejection fraction. Journal of Cardiovascular Translational Research. Epub ahead of print. Luo, Y., Ahmad, F. S., & Shah, S. J. (2017). Tensor factorization for precision medicine in heart failure with preserved ejection fraction. Journal of Cardiovascular Translational Research. Epub ahead of print.
27.
Zurück zum Zitat Williams, R. R., Rao, D. C., Ellison, R. C., Arnett, D. K., Heiss, G., Oberman, A., et al. (2000). NHLBI family blood pressure program: methodology and recruitment in the HyperGEN network. Hypertension genetic epidemiology network. Annals of Epidemiology, 10(6), 389–400.CrossRefPubMed Williams, R. R., Rao, D. C., Ellison, R. C., Arnett, D. K., Heiss, G., Oberman, A., et al. (2000). NHLBI family blood pressure program: methodology and recruitment in the HyperGEN network. Hypertension genetic epidemiology network. Annals of Epidemiology, 10(6), 389–400.CrossRefPubMed
28.
Zurück zum Zitat Devereux, R. B., Roman, M. J., de Simone, G., O’Grady, M. J., Paranicas, M., Yeh, J. L., et al. (1997). Relations of left ventricular mass to demographic and hemodynamic variables in American Indians: the Strong Heart Study. Circulation, 96(5), 1416–1423.CrossRefPubMed Devereux, R. B., Roman, M. J., de Simone, G., O’Grady, M. J., Paranicas, M., Yeh, J. L., et al. (1997). Relations of left ventricular mass to demographic and hemodynamic variables in American Indians: the Strong Heart Study. Circulation, 96(5), 1416–1423.CrossRefPubMed
29.
Zurück zum Zitat Palmieri, V., Dahlof, B., DeQuattro, V., Sharpe, N., Bella, J. N., de Simone, G., et al. (1999). Reliability of echocardiographic assessment of left ventricular structure and function: the PRESERVE study. Prospective Randomized Study Evaluating Regression of Ventricular Enlargement. Journal of the American College of Cardiology, 34(5), 1625–1632.CrossRefPubMed Palmieri, V., Dahlof, B., DeQuattro, V., Sharpe, N., Bella, J. N., de Simone, G., et al. (1999). Reliability of echocardiographic assessment of left ventricular structure and function: the PRESERVE study. Prospective Randomized Study Evaluating Regression of Ventricular Enlargement. Journal of the American College of Cardiology, 34(5), 1625–1632.CrossRefPubMed
30.
Zurück zum Zitat Sahn, D. J., DeMaria, A., Kisslo, J., & Weyman, A. (1978). Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation, 58(6), 1072–1083.CrossRefPubMed Sahn, D. J., DeMaria, A., Kisslo, J., & Weyman, A. (1978). Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation, 58(6), 1072–1083.CrossRefPubMed
31.
Zurück zum Zitat Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18(12), 1440–1463.CrossRefPubMed Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., et al. (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18(12), 1440–1463.CrossRefPubMed
32.
Zurück zum Zitat Galema, T. W., Geleijnse, M. L., Yap, S. C., van Domburg, R. T., Biagini, E., Vletter, W. B., et al. (2008). Assessment of left ventricular ejection fraction after myocardial infarction using contrast echocardiography. European Journal of Echocardiography, 9(2), 250–254.PubMed Galema, T. W., Geleijnse, M. L., Yap, S. C., van Domburg, R. T., Biagini, E., Vletter, W. B., et al. (2008). Assessment of left ventricular ejection fraction after myocardial infarction using contrast echocardiography. European Journal of Echocardiography, 9(2), 250–254.PubMed
33.
Zurück zum Zitat Peteiro, J., Pinon, P., Perez, R., Monserrat, L., Perez, D., & Castro-Beiras, A. (2007). Comparison of 2- and 3-dimensional exercise echocardiography for the detection of coronary artery disease. Journal of the American Society of Echocardiography, 20(8), 959–967.CrossRefPubMed Peteiro, J., Pinon, P., Perez, R., Monserrat, L., Perez, D., & Castro-Beiras, A. (2007). Comparison of 2- and 3-dimensional exercise echocardiography for the detection of coronary artery disease. Journal of the American Society of Echocardiography, 20(8), 959–967.CrossRefPubMed
34.
Zurück zum Zitat Aguilar, F. G., Selvaraj, S., Martinez, E. E., Katz, D. H., Beussink, L., Kim, K. Y., et al. (2016). Archeological echocardiography: digitization and speckle tracking analysis of archival echocardiograms in the HyperGEN study. Echocardiography, 33(3), 386–397.CrossRefPubMed Aguilar, F. G., Selvaraj, S., Martinez, E. E., Katz, D. H., Beussink, L., Kim, K. Y., et al. (2016). Archeological echocardiography: digitization and speckle tracking analysis of archival echocardiograms in the HyperGEN study. Echocardiography, 33(3), 386–397.CrossRefPubMed
35.
Zurück zum Zitat Hastie, T., Tibshirani, R., & Friedman, J. (2009). Unsupervised learning: hierarchical clustering. In T. Hastie, R. Tibshirani, & J. Friedman (Eds.), The elements of statistical learning (2nd ed., pp. 520–528). New York: Springer.CrossRef Hastie, T., Tibshirani, R., & Friedman, J. (2009). Unsupervised learning: hierarchical clustering. In T. Hastie, R. Tibshirani, & J. Friedman (Eds.), The elements of statistical learning (2nd ed., pp. 520–528). New York: Springer.CrossRef
36.
Zurück zum Zitat Hahsler, M., Hornik, K., & Buchta, C. (2008). Getting things in order: an introduction to the R package seriation. Journal of Statistical Software, 25(3), 1–34.CrossRef Hahsler, M., Hornik, K., & Buchta, C. (2008). Getting things in order: an introduction to the R package seriation. Journal of Statistical Software, 25(3), 1–34.CrossRef
37.
Zurück zum Zitat Fraley, C., & Raftery, A. E. (2002). Model-based clustering, discriminant analysis, and density estimation. Journal of the American Statistical Association, 97, 611–631.CrossRef Fraley, C., & Raftery, A. E. (2002). Model-based clustering, discriminant analysis, and density estimation. Journal of the American Statistical Association, 97, 611–631.CrossRef
38.
Zurück zum Zitat Hinton, G. E., & Salakhutdinov, R. R. (2006). Reducing the dimensionality of data with neural networks. Science, 313(5786), 504–507.CrossRefPubMed Hinton, G. E., & Salakhutdinov, R. R. (2006). Reducing the dimensionality of data with neural networks. Science, 313(5786), 504–507.CrossRefPubMed
39.
Zurück zum Zitat Coffman, T. M. (2011). Under pressure: the search for the essential mechanisms of hypertension. Nature Medicine, 17(11), 1402–1409.CrossRefPubMed Coffman, T. M. (2011). Under pressure: the search for the essential mechanisms of hypertension. Nature Medicine, 17(11), 1402–1409.CrossRefPubMed
40.
Zurück zum Zitat Zile, M. R., & Baicu, C. F. (2013). Biomarkers of diastolic dysfunction and myocardial fibrosis: application to heart failure with a preserved ejection fraction. Journal of Cardiovascular Translational Research, 6(4), 501–515.CrossRefPubMed Zile, M. R., & Baicu, C. F. (2013). Biomarkers of diastolic dysfunction and myocardial fibrosis: application to heart failure with a preserved ejection fraction. Journal of Cardiovascular Translational Research, 6(4), 501–515.CrossRefPubMed
41.
Zurück zum Zitat Kriegel, A. J., Gartz, M., Afzal, M. Z., de Lange, W. J., Ralphe, J. C., & Strande, J. L. (2016). Molecular approaches in HFpEF: MicroRNAs and iPSC-derived cardiomyocytes. Journal of Cardiovascular Translational Research. Epub ahead of print. Kriegel, A. J., Gartz, M., Afzal, M. Z., de Lange, W. J., Ralphe, J. C., & Strande, J. L. (2016). Molecular approaches in HFpEF: MicroRNAs and iPSC-derived cardiomyocytes. Journal of Cardiovascular Translational Research. Epub ahead of print.
Metadaten
Titel
Phenomapping for the Identification of Hypertensive Patients with the Myocardial Substrate for Heart Failure with Preserved Ejection Fraction
verfasst von
Daniel H. Katz
Rahul C. Deo
Frank G. Aguilar
Senthil Selvaraj
Eva E. Martinez
Lauren Beussink-Nelson
Kwang-Youn A. Kim
Jie Peng
Marguerite R. Irvin
Hemant Tiwari
D. C. Rao
Donna K. Arnett
Sanjiv J. Shah
Publikationsdatum
03.03.2017
Verlag
Springer US
Erschienen in
Journal of Cardiovascular Translational Research / Ausgabe 3/2017
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI
https://doi.org/10.1007/s12265-017-9739-z

Weitere Artikel der Ausgabe 3/2017

Journal of Cardiovascular Translational Research 3/2017 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.