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Current Heart Failure Reports
Published in: Current Heart Failure Reports 5/2023

Open Access 02-09-2023 | Heart Failure

Multimorbidity in Heart Failure: Leveraging Cluster Analysis to Guide Tailored Treatment Strategies

Authors: Mariëlle C. van de Veerdonk, Gianluigi Savarese, M. Louis Handoko, Joline W.J. Beulens, Folkert Asselbergs, Alicia Uijl

Published in: Current Heart Failure Reports | Issue 5/2023

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Abstract

Review Purpose

This review summarises key findings on treatment effects within phenotypical clusters of patients with heart failure (HF), making a distinction between patients with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF).

Findings

Treatment response differed among clusters; ACE inhibitors were beneficial in all HFrEF phenotypes, while only some studies show similar beneficial prognostic effects in HFpEF patients. Beta-blockers had favourable effects in all HFrEF patients but not in HFpEF phenotypes and tended to worsen prognosis in older, cardiorenal patients. Mineralocorticoid receptor antagonists had more favourable prognostic effects in young, obese males and metabolic HFpEF patients. While a phenotype-guided approach is a promising solution for individualised treatment strategies, there are several aspects that still require improvements before such an approach could be implemented in clinical practice.

Summary

Stronger evidence from clinical trials and real-world data may assist in establishing a phenotype-guided treatment approach for patient with HF in the future.
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Metadata
Title
Multimorbidity in Heart Failure: Leveraging Cluster Analysis to Guide Tailored Treatment Strategies
Authors
Mariëlle C. van de Veerdonk
Gianluigi Savarese
M. Louis Handoko
Joline W.J. Beulens
Folkert Asselbergs
Alicia Uijl
Publication date
02-09-2023
Publisher
Springer US
Published in
Current Heart Failure Reports / Issue 5/2023
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-023-00626-w

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