DECIPHER HFpEF

Diagnosing Heart Failure with Preserved Ejection Fraction Using CMR

Overview

DECIPHER HFpEF (DZHK12) is the first multicentre study worldwide on the CMR-based diagnosis of heart failure with preserved ejection fraction (HFpEF). The study aims to establish cardiovascular magnetic resonance imaging as the standard method for diagnosing HFpEF.

ClinicalTrials.gov: NCT03251183

Background

Heart failure affects approximately 2% of the Western population and 10% of people over 75 years. In about 50% of patients with heart failure, it occurs with preserved pumping ability (HFpEF). Unlike systolic heart failure, the problem in HFpEF is that the left ventricle is stiff and does not sufficiently fill with blood.

The causes of HFpEF are diverse — myocardial inflammation, fibrosis and infiltration, or disorders of the small vessels distributing the blood to the heart muscle can all lead to similar symptoms. Only once the causes are identified can patients receive targeted therapy.

Study Objectives

  1. Systematic comparison between a comprehensive CMR protocol and invasive haemodynamics (gold standard)
  2. Define histopathological drivers through myocardial biopsies
  3. Examine relations with tissue and serological biomarkers implicated in HFpEF

Study Design

  • Design: Prospective, multicenter diagnostic study
  • Status: Recruitment completed (first patient enrolled December 2017)
  • Sites: DZHK sites in Frankfurt, Mainz, Leipzig, Berlin, Heidelberg, Göttingen, Bad Nauheim

Expected Impact

If the results are positive, the study would lead to modification of guidelines for diagnosing HFpEF, enabling:

  • Non-invasive diagnosis without radiation exposure
  • Better differentiation between HFpEF subtypes
  • More targeted therapeutic approaches

Principal Investigators

  • Prof. Dr. med. Eike Nagel — University Hospital Frankfurt (Lead PI)
  • PD Dr. Valentina Puntmann — University Hospital Frankfurt

Funding

German Centre for Cardiovascular Research (DZHK)

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