title: Rationale and design of the Karolinska-Rennes (KaRen) prospective study of dyssynchrony in heart failure with preserved ejection fraction.
abstract: OBJECTIVE
  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.
  
  
  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>or=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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cardiology, CHU Pontchaillou, 35033 Rennes, France. erwan.donal@chu-rennes.fr
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lund
authors.forename: Cecilia
authors.initials: C
authors.lastname: Linde
authors.forename: Magnus
authors.initials: M
authors.lastname: Edner
authors.forename: Stéphane
authors.initials: S
authors.lastname: Lafitte
authors.forename: Hans
authors.initials: H
authors.lastname: Persson
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bauer
authors.forename: John
authors.initials: J
authors.lastname: Ohrvik
authors.forename: Pierre-Vladimir
authors.initials: PV
authors.lastname: Ennezat
authors.forename: Camilla
authors.initials: C
authors.lastname: Hage
authors.forename: Ida
authors.initials: I
authors.lastname: Löfman
authors.forename: Yves
authors.initials: Y
authors.lastname: Juilliere
authors.forename: Damien
authors.initials: D
authors.lastname: Logeart
authors.forename: Geneviève
authors.initials: G
authors.lastname: Derumeaux
authors.forename: Pascal
authors.initials: P
authors.lastname: Gueret
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Daubert
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications*; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D015337:Multicenter Studies as Topic / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012129:Respiratory Function Tests; D013318:Stroke Volume