Study background and disease burden
Heart failure (HF) constitutes a major global public health challenge, with increasing incidence, particularly among older adults. It is clinically categorized into heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF), reflecting distinct pathophysiologies and treatment paradigms. Systolic function, conventionally assessed by left ventricular ejection fraction (LVEF), and diastolic function, commonly quantified by transmitral E/A ratio, evolve dynamically with aging and cardiac remodeling. The interplay between these functions over time influences the risk of developing heart failure subtypes; however, integrated longitudinal analyses capturing concurrent systolic and diastolic trajectories have been limited. Identifying distinct trajectories could augment risk stratification and offer mechanistic insights into heart failure development, aiding early intervention and therapeutic discovery.
