Peak Strain Dispersion Reveals HFpEF Subtype Pathways

Lin et al. (PLoS Comput Biol, Jan 14, 2026) report a prospective single-center study of 150 HFpEF patients recruited December 2023–December 2024, using K-means clustering and SHAP-augmented ensemble models to identify subtypes and mechanisms. They retained 84 complete cases, found two clusters with distinct age and renal profiles, showed PSD as the top SHAP predictor (R²=0.58–0.61 for myocardial work) and demonstrated subtype-specific nonlinear PSD mediation of eGFR and BNP effects.