A hemodynamic and biomarker study of pulmonary hypertension associated with heart failure: DISCOVER PH-HF

The pathogenesis of pulmonary hypertension associated with heart failure (PH-HF) is partially understood. To advance knowledge in this regard, the investigator-initiated, public-funded, prospective, translational stuDy to dISseCt remOdeling of capillaries and Veins in pulmonary hypErtension associated with heaRt failure (DISCOVER PH-HF) will assess biomarkers of PH-HF in pulmonary capillary and venous (PCV) and peripheral venous blood taken during right heart catheterization (RHC). This report presents the design of DISCOVER PH-HF and the baseline characteristics of the included patients.

DISCOVER PH-HF enrolled heart failure patients scheduled for transcatheter edge-to-edge repair (TEER) of severe mitral regurgitation. PCV and peripheral venous whole blood was collected during RHC within 48 h before mitral regurgitation (MR)-TEER, and processed into plasma/serum aliquots and peripheral blood mononuclear cell (PBMC) pellets. Then, the samples were centralized to a core biobank. Follow-up entails visits at 90 ± 10 and 180 ± 10 days and - optionally - a second RHC with collection of PCV and peripheral venous blood within 30 days from the second follow-up evaluation. A proteomic analysis of part of the PCV and peripheral plasma is already planned.

Seven patients without pulmonary hypertension at RHC, 12 patients with isolated postcapillary pulmonary hypertension, and 18 patients with combined postcapillary and precapillary pulmonary hypertension were recruited, leading to a total of 148 PCV and 148 peripheral plasma aliquots, 111 PCV and 111 peripheral serum aliquots, and 37 PBMC pellets.

DISCOVER PH-HF has generated a limited-size, but unique biobank of RHC-derived PCV and peripheral venous blood samples and PBMCs, linked to clinical and hemodynamic phenotyping, which will allow the exploration of biomarkers of PH-HF and its subtypes.