Uncovering Distinct Phenotypes of Early Onset Heart Failure in Women

Four distinct phenotypes of early-onset heart failure were identified in 1,407 women aged 18–55, including hypertensive pregnancy (n=494) and cardiorenal (n=276), with moderate clustering quality.

• Why it matters: Conventional heart-failure classifications may miss heterogeneous pathways and risk in younger women, limiting prognostic precision and generalizability across health systems.
• What they did: Using electronic health record data from a multi-hospital system, the study applied an unsupervised variational deep embedding model with 283 clinical features, then tested outcomes with age-stratified Cox models and replicated clustering in All of Us (n=682).
• The result: Compared with hypertensive pregnancy, inpatient hospitalization and mortality were highest in cardiorenal (HR 2.86; HR 4.65) and autoimmune (HR 2.25; HR 4.38), and transferred phenotypes retained key characteristics with strongest replication for cardiorenal (Jaccard index, 0.744).

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