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Improving diagnosis and risk stratification across the ejection fraction spectrum: the Maastricht Cardiomyopathy
Michiel T H M Henkens1,2,3, Jerremy Weerts1, Job A J Verdonschot1,4
1Department of Cardiology, CARIM, Maastricht University Medical Centre, Maastricht, The Netherlands.
Insights
The Maastricht Cardiomyopathy registry enhances heart failure diagnosis and management. This prospective study aims to improve risk stratification for cardiomyopathies beyond left ventricular ejection fraction (LVEF) limits.
Area of Science:
- Cardiology
- Genetics
- Clinical Research
Background:
- Heart failure (HF) arises from diverse causes, with cardiomyopathies playing a key role.
- Cardiomyopathies result from genetic and environmental factors, impacting heart muscle function.
- Current diagnostic and management strategies for HF and cardiomyopathies have limitations, particularly concerning left ventricular ejection fraction (LVEF).
Purpose of the Study:
- To establish the Maastricht Cardiomyopathy registry (mCMP-registry) for improved diagnosis, risk stratification, and management of cardiomyopathy phenotypes.
- To advance understanding of cardiomyopathies beyond the traditional LVEF assessment.
- To facilitate collaborative research by enabling other centers to join the initiative.
Main Methods:
- Prospective, investigator-initiated registry including patient characteristics, clinical data, biobanking, and quality of life assessments.
- Inclusion of patients aged ≥16 years with HF-like symptoms or cardiomyopathy screening at Maastricht University Medical Center (MUMC+).
- Utilizing both data-driven and hypothesis-driven approaches for outcome prediction, therapy response, and clinical parameter evaluation over a 15-year follow-up period.
Main Results:
- The registry collects comprehensive data including patient characteristics, routine diagnostic measurements, treatment details, sequential biobanking, quality of life, and economic impact.
- A broad inclusion criterion allows for the enrollment of diverse cardiomyopathy phenotypes and underlying causes.
- The study is designed for a 15-year follow-up of consented subjects.
Conclusions:
- The mCMP-registry offers a unique platform for advancing HF and cardiomyopathy care.
- Systematic data collection, biobanking, and a multidisciplinary approach enhance diagnostic and prognostic capabilities.
- The registry aims to improve patient outcomes by moving beyond LVEF limitations in managing cardiomyopathies.
Aims:
Heart failure (HF) represents a clinical syndrome resulting from different aetiologies and degrees of heart diseases. Among these, a key role is played by primary heart muscle disease (cardiomyopathies), which are the combination of multifactorial environmental insults in the presence or absence of a known genetic predisposition. The aim of the Maastricht Cardiomyopathy registry (mCMP-registry; NCT04976348) is to improve (early) diagnosis, risk stratification, and management of cardiomyopathy phenotypes beyond the limits of left ventricular ejection fraction (LVEF).
Methods And Results:
The mCMP-registry is an investigator-initiated prospective registry including patient characteristics, diagnostic measurements performed as part of routine clinical care, treatment information, sequential biobanking, quality of life and economic impact assessment, and regular follow-up. All subjects aged ≥16 years referred to the cardiology department of the Maastricht University Medical Center (MUMC+) for HF-like symptoms or cardiac screening for cardiomyopathies are eligible for inclusion, irrespective of phenotype or underlying causes. Informed consented subjects will be followed up for 15 years. Two central approaches will be used to answer the research questions related to the aims of this registry: (i) a data-driven approach to predict clinical outcome and response to therapy and to identify clusters of patients who share underlying pathophysiological processes; and (ii) a hypothesis-driven approach in which clinical parameters are tested for their (incremental) diagnostic, prognostic, or therapeutic value. The study allows other centres to easily join this initiative, which will further boost research within this field.
Conclusions:
The broad inclusion criteria, systematic routine clinical care data-collection, extensive study-related data-collection, sequential biobanking, and multi-disciplinary approach gives the mCMP-registry a unique opportunity to improve diagnosis, risk stratification, and management of HF and (early) cardiomyopathy phenotypes beyond the LVEF limits.