Pilot 2.2

Prevention and screening of asymptomatic left ventricular dysfunction in Val BRembana / Valle IMagna / BERGamo (The BRIMBERG Study).

Heart failure (HF) is a major health care issue, associated with high morbidity and mortality. Early recognition of left ventricular dysfunction preceding HF, as well as early diagnosis of HF is of pivotal importance to implement disease-modifying treatments. 

We plan to i) obtain a historical epidemiological perspective on the relationship between cardiovascular risk (i.e. hypertension, diabetes mellitus, obesity), socio-economic and geographical factors, and HF development, that may aid interpreting the healthcare situation in the area of interest, as well as predisposing factors, and their changes over time; ii) obtain a contemporary epidemiological snapshot on the prevalence of symptoms and cardiac abnormalities suggestive for HF in a population at risk but which have been misinterpreted resulting in an incorrect diagnosis, that will be enriched with circulating biomarkers, pathophysiologically meaningful cardiorespiratory exercise-stress data (since symptoms and abnormalities may be evidenced during stress condition rather than at rest), and biological signals obtained during daily life through wearable devices; iii) evaluate the relationship of pre-clinical, asymptomatic abnormalities that may either due to HF or to ageing, detected through different techniques (e.g. blood tests, echocardiography, cardiorespiratory adaptation to exercise); iv) gain insights in HF pathophysiology through a comprehensive patients’ evaluation; v) employ artificial intelligence on raw data in order to try to overcome the complexity of pre-clinical HF diagnosis, and to enhance screening procedures; vi) link outcomes data to specific abnormalities evident on standard exams performed during the initial evaluation as well as on artificial intelligence applied to ECG, echocardiography, and wearable data, in order to refine diagnostic and risk stratification procedures; vii) evaluate the role of circulating biomarkers, proteomic and metabolomic analysis in the diagnostic and prognostic stratification of individuals; viii) identify the ideal characteristics of a target population on which apply a cost-effective screening strategy for HF.