Trial reportJournal of the American College of Cardiology2014
Clinical implications of chronic heart failure phenotypes defined by cluster analysis.
Trial report in Journal of the American College of Cardiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00047437 (Heart Failure), which is not on this map. Cited by 141 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION)
Who cites it
141 citing papers in PubMed, 2 syntheses or guidelines pooled it, 263 citations in OpenAlex.
- Discovering Distinct Phenotypical Clusters in Heart Failure Across the Ejection Fraction Spectrum: a Systematic Review.Current heart failure reports · 2023Pooled it
- Pooled it
- Impact of behavioral phenotypes on response to a digital intervention to improve physical activity among postpartum individuals with hypertensive disorders of pregnancy.Hypertension in pregnancy · 2025Trial
- Phenomapping the Response of Patients With Ischemic Cardiomyopathy With Reduced Ejection Fraction to Surgical Revascularization.Clinical cardiology · 2025Trial
- Machine Learning-Driven Phenogrouping and Cardiorespiratory Fitness Response in Metastatic Breast Cancer.JCO clinical cancer informatics · 2024Trial
- Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes.ESC heart failure · 2021Trial
- Characterization of subgroups of heart failure patients with preserved ejection fraction with possible implications for prognosis and treatment response.European journal of heart failure · 2015Trial
- Unsupervised Descriptive Phenotyping of Cardiometabolic Laboratory Patterns from a Routine Five-Analyte Panel: Stability, Transportability and a Rule-Based Laboratory Interpretation Layer.Diagnostics (Basel, Switzerland) · 2026Article
- Integration of the circulating miRNome and clinical information to predict 90-day mortality in elderly COVID-19 subphenotypes.iScience · 2026Article
- Exploratory Mixed-Data Phenomapping and Risk-Enrichment Frameworks for Long-Term Mortality After Acute Coronary Syndrome: A Single-Center Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Histological and clinical phenotypes of diabetic kidney disease: a baseline analysis of the HEROIC study.Clinical kidney journal · 2026Article
- Unsupervised Clinical Phenotyping Identifies Distinct Risk Profiles in Incisional Hernia Repair.Medicina (Kaunas, Lithuania) · 2026Article
- Phenotype-stratified treatment response in obese atrial fibrillation: Post-hoc cluster analysis of the PRAGUE-25 randomized trial.International journal of cardiology. Heart & vasculature · 2026Article
- Proteomic phenotyping with machine learning for cardiovascular outcomes in haemodialysis: insights from the AURORA trial.European heart journal. Digital health · 2026Article
- Risk Stratification and Outcome Prediction in Heart Failure Patients With Cardiac Implantable Electronic Devices Using Machine Learning Analysis From the HINODE Study.Circulation reports · 2026Article
- Phenomapping in Heart Failure With Reduced Ejection Fraction to Identify Subpopulations With High Residual Risk: A VICTORIA Substudy.Circulation. Heart failure · 2026Article
- Unbiased Characterization of Atrial Fibrillation Phenotypic Architecture Provides Insight Into Genetic Liability and Clinically Relevant Outcomes.Circulation. Genomic and precision medicine · 2026Article
- Blood Pressure and Hypertension Among Adults Aged 80 and Above: Findings From the Population-Based German Health Survey Gesundheit 65.International journal of hypertension · 2026Article
- Review
- Structural brain injury on magnetic resonance imaging in heart failure and identifying patients at high-risk.Cerebral circulation - cognition and behavior · 2026Article
81 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundClassification of chronic heart failure (HF) is on the basis of criteria that may not adequately capture disease heterogeneity. Improved phenotyping may help inform research and therapeutic strategies.
objectivesThis study used cluster analysis to explore clinical phenotypes in chronic HF patients.
methodsA cluster analysis was performed on 45 baseline clinical variables from 1,619 participants in the HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) study, which evaluated exercise training versus usual care in chronic systolic HF. An association between identified clusters and clinical outcomes was assessed using Cox proportional hazards modeling. Differential associations between clinical outcomes and exercise testing were examined using interaction testing.
resultsFour clusters were identified (ranging from 248 to 773 patients in each), in which patients varied considerably among measures of age, sex, race, symptoms, comorbidities, HF etiology, socioeconomic status, quality of life, cardiopulmonary exercise testing parameters, and biomarker levels. Differential associations were observed for hospitalization and mortality risks between and within clusters. Compared with cluster 1, risk of all-cause mortality and/or all-cause hospitalization ranged from 0.65 (95% confidence interval [95% CI]: 0.54 to 0.78) for cluster 4 to 1.02 (95% CI: 0.87 to 1.19) for cluster 3. However, for all-cause mortality, cluster 3 had a disproportionately lower risk of 0.61 (95% CI: 0.44 to 0.86). Evidence suggested differential effects of exercise treatment on changes in peak oxygen consumption and clinical outcomes between clusters (p for interaction <0.04).
conclusionsCluster analysis of clinical variables identified 4 distinct phenotypes of chronic HF. Our findings underscore the high degree of disease heterogeneity that exists within chronic HF patients and the need for improved phenotyping of the syndrome. (Exercise Training Program to Improve Clinical Outcomes in Individuals With Congestive Heart Failure; NCT00047437).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.