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European Journal of Heart Failure 2009 11(2):198-204; doi:10.1093/eurjhf/hfn025
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Rationale and design of the Karolinska-Rennes (KaRen) prospective study of dyssynchrony in heart failure with preserved ejection fraction

Erwan Donal1,*, Lars H. Lund2, Cecilia Linde2, Magnus Edner3, Stéphane Lafitte4, Hans Persson3, Fabrice Bauer5, John Öhrvik2, Pierre-Vladimir Ennezat6, Camilla Hage2, Ida Löfman2, Yves Juilliere7, Damien Logeart8, Geneviève Derumeaux9, Pascal Gueret10 and Jean-Claude Daubert1

1 Cardiology, CHU Pontchaillou, 35033 Rennes, France
2 Cardiology, Karolinska University Hospital, Stockholm, Sweden
3 Cardiology, Danderyd University Hospital, Stockholm, Sweden
4 Cardiology, Haut-Lévêque University Hospital, Pessac, France
5 Cardiology, Charles Nicolle University Hospital, Rouen, France
6 Cardiology, Hôpital Cardiologique, CHU Lille, France
7 Cardiology, CHU Nancy, France
8 Cardiology, Hôpital Lariboisière, Paris, France
9 Cardiology, Hôpital Louis Pradel, Lyon, France
10 Cardiology, CHU Henri-Mondor, Créteil, France

* Corresponding author. Tel: +33 299282525, Fax: +33 299282510, Email: erwan.donal{at}chu-rennes.fr


  Abstract

Aims: Heart failure with preserved ejection fraction (HFPEF) is common but not well understood. Electrical dyssynchrony in systolic heart failure is harmful. Little is known about the prevalence and the prognostic impact of dyssynchrony in HFPEF.

Methods and results: We have designed a prospective, multicenter, international, observational study to characterize HFPEF and to determine whether electrical or mechanical dyssynchrony affects prognosis. Patients presenting with acute heart failure (HF) will be screened so as to identify 400 patients with HFPEF. Inclusion criteria will be: acute presentation with Framingham criteria for HF, left ventricular ejection fraction ≥ 45%, brain natriuretic peptide (BNP) > 100 pg/mL or NT-proBNP > 300 pg/mL. Once stabilized, 4–8 weeks after the index presentation, patients will return and undergo questionnaires, serology, ECG, and Doppler echocardiography. Thereafter, patients will be followed for mortality and HF hospitalization every 6 months for at least 18 months. Sub-studies will focus on echocardiographic changes from the acute presentation to the stable condition and on exercise echocardiography, cardiopulmonary exercise testing, and serological markers.

Conclusion: KaRen aims to characterize electrical and mechanical dyssynchrony and to assess its prognostic impact in HFPEF. The results might improve our understanding of HFPEF and generate answers to the question whether dyssynchrony could be a target for therapy in HFPEF.

Key Words: Heart failure • Preserved ejection fraction • Diastolic dysfunction • Dyssynchrony • Echocardiography

Received June 9, 2008; Revised August 26, 2008; Accepted November 10, 2008


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Home page
 Eur J Heart FailHome page
E. Donal, L. H. Lund, E. Oger, M. Edner, H. Persson, and For the KaRen study investigators
What are the true prognostic differences between heart failure with preserved and reduced ejection fraction?
Eur J Heart Fail, January 1, 2010; 12(1): 98 - 98.
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