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

Aims – 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. Methods – 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. Results – 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. Conclusion – 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.