Heart Failure
Conditions
Keywords
Prevalence, Heart failure
Brief summary
This study aims to determine the prevalence of heart failure in the resident population in mainland Portugal aged 50 years or above, using a contemporary, guideline-based diagnostic approach, to optimize patient management and improve strategic healthcare decision-making
Detailed description
The contemporary prevalence of heart failure in Portugal is largely unknown and may differ from that reported in early studies, which were conducted in the late 1990s-early 2000s with the diagnostic techniques available at the time and did not include neither advanced echocardiographic parameters nor natriuretic peptides measurements. Thus, a large and representative study is needed to address knowledge gaps on the epidemiology, characteristics and burden of heart failure in Portugal. The study aims to determine the prevalence of global heart failure, as well as heart failure subtypes. It also aims to assess the distribution of comorbidities among patients with heart failure, as well as patients' health-related quality of life. The Investigators will conduct a population-based study with a three-stage design approach, enrolling 5616 subjects aged 50 years or above, randomly selected through multi-stage sampling, using the National Health Service as reference: PHASE 0 - Participant selection/enrollment through phone call; PHASE 1 - Screening (NT-proBNP levels determination), health-related quality of life evaluation and sociodemographic characterization; PHASE 2 - Confirmatory assessment with a 12-lead electrocardiography, comprehensive transthoracic echocardiography, extended symptoms assessment and biomarkers assessment; PHASE 3 - Heart failure with preserved ejection fraction exertion testing through a non-invasive echocardiographic diastolic stress test.
Interventions
None listed
Sponsors
Sociedade Portuguesa de Cardiologia
NOVA Medical School
AstraZeneca
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Community-dwelling citizens living in Mainland Portugal; * Registration in a primary care centre; * Age ≥50 years at recruitment; * Voluntary signed informed consent.
Exclusion criteria
* Living in institutions (e.g., nursing homes, prisons, military facilities, hospitals); * Non-Portuguese speakers; * Reduced physical and/or cognitive ability hampering participation (e.g., blindness, deafness, or cognitive impairment).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of HF among the mainland resident Portuguese population aged 50 or above. | Between March 2022 and March 2023 | Prevalence of HF among the mainland resident Portuguese population aged 50 or above. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart Failure mildly reduced Ejection Fraction phenotype prevalence | Between March 2022 and March 2023 | Heart Failure mildly reduced Ejection Fraction phenotype prevalence |
| Heart Failure preserved Ejection Fraction phenotype prevalence. | Between March 2022 and March 2023 | Heart Failure preserved Ejection Fraction phenotypes prevalence. |
| Prevalence of asymptomatic NT-proBNP elevation. | Between March 2022 and March 2023 | Prevalence of asymptomatic NT-proBNP elevation. |
| Prevalence of Pre-HF, as defined by the HF universal definition 2, in patients with asymptomatic NT-proBNP elevation. | Between March 2022 and March 2023 | Prevalence of Pre-HF, as defined by the HF universal definition 2, in patients with asymptomatic NT-proBNP elevation. |
| Prevalence of comorbidities among Portuguese HF patients | Between March 2022 and March 2023 | Prevalence of comorbidities among Portuguese HF patients, namely: 1. CHD, 2. previous MI, 3. hypertension, 4. obesity, 5. DM, 6. VHD, 7. AF, 8. CKD, 9. COPD, 10. OSA; |
| Prevalence of comorbidities among patients with HFrEF, HFmrEF, and HFpEF phenotypes. | Between March 2022 and March 2023 | Prevalence of comorbidities among patients with HFrEF, HFmrEF, and HFpEF phenotypes, namely: 1. CHD, 2. previous MI, 3. hypertension, 4. obesity, 5. DM, 6. VHD, 7. AF, 8. CKD, 9. COPD, 10. OSA. |
| Health-related quality of life 5-level Euro Quality of life-5D version (EQ-5D-5L) | Between March 2022 and March 2023 | Health-related quality of life 5-level Euro Quality of life-5D version (EQ-5D-5L) consists of 2 pages: the descriptive system (EQ-5D) and the visual analogue scale (EQ VAS). EQ-5D comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression; each one has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the 5 dimensions can be combined into a 5-digit number that describes the patient's health state. The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' (100) and 'The worst health you can imagine' (0). |
| Health-related quality of life (Kansas City Cardiomyopathy Questionnaire - KCCQ) | Between March 2022 and March 2023 | Health-related quality of life (Kansas City Cardiomyopathy Questionnaire - KCCQ). The predictor was the annually updated KCCQ score. The KCCQ is a validated instrument to assess health status among persons with heart failure. The self-administered questionnaire includes 23-items which quantify the importance of dyspnea, fatigue, and edema on physical, social, and emotional functions. The responses are categorized under 3 subscales (symptom burden, physical limitation and quality of life) with a range of possible subscale scores from 0 to 100, with 100 representing the least burden of symptoms. The total KCCQ score represents the mean of the three subscale scores. |
| Association between health-related quality of life questionnaire (EQ-5D-5L) results and the HF phenotype. | Between March 2022 and March 2023 | Association between health-related quality of life questionnaire (EQ-5D-5L) results and the HF phenotype. |
| Association between health-related quality of life questionnaire (KCCQ) results and the HF phenotype. | Between March 2022 and March 2023 | Association between health-related quality of life questionnaire (KCCQ) results and the HF phenotype. |
| Age- and gender-specific prevalence of HF among the Portuguese population. | Between March 2022 and March 2023 | Age- and gender-specific prevalence of HF among the Portuguese population. |
| Heart Failure reduced Ejection Fraction phenotype prevalence. | Between March 2022 and March 2023 | Heart Failure reduced Ejection Fraction phenotype prevalence. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Exploratory Outcome: Association between biomarkers of interest (HbA1c%) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (HbA1c%) and HF prevalence. |
| Exploratory Outcome: Association between biomarkers of interest (serum creatinine) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (serum creatinine) and HF prevalence. |
| Exploratory Outcome: Association between biomarkers of interest (C-reactive protein) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (C-reactive protein) and HF prevalence. |
| Exploratory Outcome: Association between biomarkers of interest (troponin) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (troponin) and HF prevalence. |
| Exploratory Outcome: Association between biomarkers of interest (lipids) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (lipids) and HF prevalence. |
| Exploratory Outcome: Association between biomarkers of interest (HF biomarkers) and HF prevalence. | Between March 2022 and March 2023 | Association between biomarkers of interest (HF biomarkers) and HF prevalence. |
| Exploratory Outcome: Distribution of HF according to geographical area using NUTS II segmentation. | Between March 2022 and March 2023 | Distribution of HF according to geographical area using NUTS II segmentation. |
| Exploratory Outcome: Association between diabetes mellitus and HF prevalence. | Between March 2022 and March 2023 | Association between diabetes mellitus and HF prevalence. |
| Exploratory Outcome: Association between pre-diabetes and HF prevalence. | Between March 2022 and March 2023 | Association between pre-diabetes and HF prevalence. |
Countries
Portugal
Outcome results
None listed