Publications

BibTex format

@article{Tayal:2022:10.1016/j.jacc.2022.03.375,
author = {Tayal, U and Verdonschot, JAJ and Hazebroek, MR and Howard, J and Gregson, J and Newsome, S and Gulati, A and Pua, CJ and Halliday, BP and Lota, AS and Buchan, RJ and Whiffin, N and Kanapeckaite, L and Baruah, R and Jarman, JWE and O'Regan, DP and Barton, PJR and Ware, JS and Pennell, DJ and Adriaans, BP and Bekkers, SCAM and Donovan, J and Frenneaux, M and Cooper, LT and Januzzi, JL and Cleland, JGF and Cook, SA and Deo, RC and Heymans, SRB and Prasad, SK},
doi = {10.1016/j.jacc.2022.03.375},
journal = {Journal of the American College of Cardiology},
pages = {2219--2232},
title = {Precision phenotyping of dilated cardiomyopathy using multidimensional data.},
url = {http://dx.doi.org/10.1016/j.jacc.2022.03.375},
volume = {79},
year = {2022}
}

Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Dilated cardiomyopathy (DCM) is a final common manifestation of heterogenous etiologies. Adverse outcomes highlight the need for disease stratification beyond ejection fraction. OBJECTIVES: The purpose of this study was to identify novel, reproducible subphenotypes of DCM using multiparametric data for improved patient stratification. METHODS: Longitudinal, observational UK-derivation (n = 426; median age 54 years; 67% men) and Dutch-validation (n = 239; median age 56 years; 64% men) cohorts of DCM patients (enrolled 2009-2016) with clinical, genetic, cardiovascular magnetic resonance, and proteomic assessments. Machine learning with profile regression identified novel disease subtypes. Penalized multinomial logistic regression was used for validation. Nested Cox models compared novel groupings to conventional risk measures. Primary composite outcome was cardiovascular death, heart failure, or arrhythmia events (median follow-up 4 years). RESULTS: In total, 3 novel DCM subtypes were identified: profibrotic metabolic, mild nonfibrotic, and biventricular impairment. Prognosis differed between subtypes in both the derivation (P < 0.0001) and validation cohorts. The novel profibrotic metabolic subtype had more diabetes, universal myocardial fibrosis, preserved right ventricular function, and elevated creatinine. For clinical application, 5 variables were sufficient for classification (left and right ventricular end-systolic volumes, left atrial volume, myocardial fibrosis, and creatinine). Adding the novel DCM subtype improved the C-statistic from 0.60 to 0.76. Interleukin-4 receptor-alpha was identified as a novel prognostic biomarker in derivation (HR: 3.6; 95% CI: 1.9-6.5; P = 0.00002) and validation cohorts (HR: 1.94; 95% CI: 1.3-2.8; P = 0.00005). CONCLUSIONS: Three reproducible, mechanistically distinct DCM subtypes were identified using widely available clinical and biological data, adding prognostic value to trad
AU  - Tayal,U
AU  - Verdonschot,JAJ
AU  - Hazebroek,MR
AU  - Howard,J
AU  - Gregson,J
AU  - Newsome,S
AU  - Gulati,A
AU  - Pua,CJ
AU  - Halliday,BP
AU  - Lota,AS
AU  - Buchan,RJ
AU  - Whiffin,N
AU  - Kanapeckaite,L
AU  - Baruah,R
AU  - Jarman,JWE
AU  - O'Regan,DP
AU  - Barton,PJR
AU  - Ware,JS
AU  - Pennell,DJ
AU  - Adriaans,BP
AU  - Bekkers,SCAM
AU  - Donovan,J
AU  - Frenneaux,M
AU  - Cooper,LT
AU  - Januzzi,JL
AU  - Cleland,JGF
AU  - Cook,SA
AU  - Deo,RC
AU  - Heymans,SRB
AU  - Prasad,SK
DO  - 10.1016/j.jacc.2022.03.375
EP  - 2232
PY  - 2022///
SN  - 0735-1097
SP  - 2219
TI  - Precision phenotyping of dilated cardiomyopathy using multidimensional data.
T2  - Journal of the American College of Cardiology
UR  - http://dx.doi.org/10.1016/j.jacc.2022.03.375
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35654493
UR  - https://www.sciencedirect.com/science/article/pii/S0735109722046861?via%3Dihub
UR  - http://hdl.handle.net/10044/1/97196
VL  - 79
ER  -

Download

ProfessorSanjayPrasad

Contact

Location

Summary

Citation

BibTex format

RIS format (EndNote, RefMan)