Detection of Early Heart Failure with Preserved Ejection Fraction (HFpEF) in Metabolic Syndrome Patients Detected as Part of a National Screening Programme in Middle Aged Subjects


  • Jelena Čelutkienė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Aistė Monika Jakštaitė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Jolita Badarienė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Svetlana Solovjova Santariškių 2, LT-08661 Vilnius, Lithuania
  • Ieva Slivovskaja Santariškių 2, LT-08661 Vilnius, Lithuania
  • Rokas Navickas Santariškių 2, LT-08661 Vilnius, Lithuania
  • Edita Kazėnaitė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Egidija Rinkūnienė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Alma Čypienė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Jonas Misiūra Santariškių 2, LT-08661 Vilnius, Lithuania
  • Ligita Ryliškytė Santariškių 2, LT-08661 Vilnius, Lithuania
  • Aleksandras Laucevičius Santariškių 2, LT-08661 Vilnius, Lithuania
  • Andrew Coats Editor-in-Chief, Academic Vice-President, Monash University, Australia and University of Warwick, UK



heart failure with preserved ejection fraction, metabolic syndrome, arterial stiffness, early detection


Aims: To investigate if community detected Metabolic Syndrome (MetS) is associated with the burden of incipient HFpEF in the community. Methods and Results: We prospectively studied 148 consecutive MetS patients identified from the Lithuanian High Cardiovascular Risk primary prevention programme and investigated them further for unknown HFpEF through cardiopulmonary stress testing as well as assessment of BNP levels and of arterial stiffness. Subjects with a peak VO2 value lower than 90% of predicted and/or BNP≥35 ng/l were categorized as having early phase HFpEF. For comparison of this early phase HFpEF with others already clinically diagnosed with HFpEF, patients with both established HFpEF and MetS were selected retrospectively from patients attending our cardiopulmonary stress testing laboratory (n=38). Two thirds of the screening programme-derived MetS population (n=96) demonstrated a reduced exercise capacity and/or an elevated BNP, indicating signs of early HFpEF. Both the clinically diagnosed HFpEF and the screening programme detected MetS group with early HFpEF demonstrated similarly decreased exercise tolerance evaluated by peak oxygen uptake (79.8 ± 22.1% vs 82.7 ± 14.0%, p>0.05). Analysis of arterial markers in the screening programme group revealed statistically significant differences of augmentation index values between groups with and without signs of early HFpEF (p=0.016).Conclusion: A considerable proportion of patients having MetS may be diagnosed with previously undetected early stage HFpEF. The use of objective parameters of exercise capacity and neurohormonal activation might be effectively used for the early detection of HFpEF. Also early HFpEF in this setting is found to be associated with increased arterial stiffness.


Author Biography

Andrew Coats, Editor-in-Chief, Academic Vice-President, Monash University, Australia and University of Warwick, UK

Andrew holds a MB and BChir from Cambridge, an MA and DM from Oxford, a DSc. from Imperial College, and an MBA from London Business School. Andrew served as the Inaugural Viscount Royston Professor of Cardiology at the National Heart and Lung Institute in London, as Director of Cardiology of the Royal Brompton and Harefield NHS trust as Head of Clinical Cardiology at Imperial College, as Dean of Medicine at the University of Sydney, as Deputy Vice-Chancellor of Sydney, and as CEO of the Norwich Research Park. He is presently Academic Vice-President of Monash University, Australia and the University of Warwick, UK and Director of the Monash-Warwick Alliance.

Andrew has published in excess of 1400 publications and has more than 52,000 career citations, and a personal H-index of 106. He has been Editor-in-Chief of the International Journal of Cardiology since 1999 and has received the Linacre Medal of the Royal College of Physicians and the inaugural Michael L Pollock award of the American Heart Association. He has been Chairman or Committee member of the following major Cardiovascular Trials: CHRISTMAS, CHARM, COPERNICUS, OXAM, OPTIMAAL, OVERTURE, REPLACE and SENIORS. Andrew also has more than 20 patents, and has two successful spin-out companies which have generated more than £30Million in investment.  

Andrew has more than 30 board years of experience as a director across the health and biotechnology, sectors (including Myotec, PsiOxus, Cardiodirect, Primary Heart Care, Lone Star Heart Inc, the Harley Street Group) and in the not-for-profit sector (including the George Institute, the Centenary Institute, ANZAC Institute of Medical Research, Sydney Cancer Centre Foundation, Colney Innovations Limited, and the Woolcock Institute of Medical Research).


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