Significance of myocardial tenascin‐C expression in left ventricular remodelling and long‐term outcome in patients with dilated cardiomyopathy

Purpose: Left ventricular global function index (LVGFI) assessed using cardiac magnetic resonance (CMR) seems promising in the prediction of clinical outcomes. However, the role of the LVGFI is uncertain in patients with heart failure (HF) with dilated cardiomyopathy (DCM). To describe the association of LVGFI and outcomes in patients with DCM, it was hypothesized that LVGFI is associated with decreased major adverse cardiac events (MACEs) in patients with DCM.Materials and Methods: This prospective cohort study was conducted from January 2015 to April 2020 in consecutive patients with DCM who underwent CMR. The association between outcomes and LVGFI was assessed using a multivariable model adjusted with confounders. LVGFI was the primary exposure variable. The long-term outcome was a composite endpoint, including death or heart transplantation.Results: A total of 334 patients (mean age: 55 years) were included in this study. The average of CMR-LVGFI was 16.53%. Over a median follow-up of 565 days, 43 patients reached the composite endpoint. Kaplan–Meier analysis revealed that patients with LVGFI lower than the cutoff values (15.73%) had a higher estimated cumulative incidence of the endpoint compared to those with LVGFI higher than the cutoff values (P = 0.0021). The hazard of MACEs decreased by 38% for each 1 SD increase in LVGFI (hazard ratio 0.62[95%CI 0.43–0.91]) and after adjustment by 46% (HR 0.54 [95%CI 0.32–0.89]). The association was consistent across subgroup analyses.Conclusion: In this study, an increase in CMR-LVGFI was associated with decreasing the long-term risk of MACEs with DCM after adjustment for traditional confounders.

Download Full-text

Long-term outcome in patients with idiopathic dilated cardiomyopathy after weaning from left ventricular assist devices

The Journal of Heart and Lung Transplantation ◽

10.1016/j.healun.2004.11.221 ◽

2005 ◽

Vol 24 (2) ◽

pp. S107 ◽

Cited By ~ 2

Author(s):

M. Dandel ◽

Y. Weng ◽

H. Siniawski ◽

E. Potapov ◽

R. Hetzer

Keyword(s):

Dilated Cardiomyopathy ◽

Left Ventricular ◽

Ventricular Assist Devices ◽

Idiopathic Dilated Cardiomyopathy ◽

Left Ventricular Assist Devices ◽

Term Outcome ◽

Ventricular Assist ◽

Long Term Outcome ◽

Left Ventricular Assist

Download Full-text

Impact of left ventricular diastolic dysfunction on long-term outcome in patients with lower extremity artery disease

Journal of Cardiology ◽

10.1016/j.jjcc.2019.12.011 ◽

2020 ◽

Vol 75 (6) ◽

pp. 659-664

Author(s):

Koji Yanaka ◽

Hirokuni Akahori ◽

Takahiro Imanaka ◽

Kojiro Miki ◽

Nagataka Yoshihara ◽

...

Keyword(s):

Lower Extremity ◽

Diastolic Dysfunction ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Term Outcome ◽

Long Term Outcome ◽

Ventricular Diastolic Dysfunction ◽

Artery Disease ◽

Lower Extremity Artery Disease

Download Full-text

Systolic blood pressure and outcome in patients admitted with acute heart failure: a pooled analysis from 4 randomized clinical trials

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.045 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

J Grand ◽

K Miger ◽

A Sajadieh ◽

L Kober ◽

C Torp-Pedersen ◽

...

Keyword(s):

Heart Failure ◽

Composite Endpoint ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Term Outcome ◽

Ventricular Ejection Fraction ◽

Long Term Outcome ◽

All Cause Mortality ◽

Short And Long Term

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Background In acute heart failure (AHF), low systolic blood pressure (SBP) has been associated with poor outcome. Less is known of the risk related to normal versus elevated SBP and interaction with left ventricular ejection fraction. Purpose The aim of the present study was to assess the association between baseline SBP and short- and long-term outcome in a large cohort of AHF-patients. Methods A pooled cohort of four randomized controlled trials investigating the vasodilator serelaxin versus placebo in patients admitted with AHF and an SBP from 125 to 180 mmHg. Endpoints were 180-day all-cause mortality and a short-term composite endpoint (worsening heart failure, all-cause mortality or hospital readmission for HF through Day 14). Left ventricular ejection fraction (LVEF) was categorized into HFrEF (<40%) and HFpEF (= >40%). Multivariable Cox regression was used and adjusted for age, sex, baseline body mass index, HFrEF, serum estimated glomerular filtration rate, allocated treatment (placebo/serelaxin), diabetes mellitus, ischemic heart disease, and atrial fibrillation/flutter. Measurements and Main Results A total of 10.533 patients with a mean age of 73 (±12) years and median SBP of 140 (130-150) mmHg were included within mean 8.2 hours from admission. LVEF was assessed in 8493 (81%), and of these, 4294 (51%) had HFrEF. Increasing SBP as a continuous variable was inversely associated with 180-day mortality (HRadjusted: 0.93 [0.88-0.98], p = 0.004 per 10 mmHg increase) and with the composite endpoint (HRadjusted: 0.90 [0.85-0.95], p < 0.0001 per 10 mmHg increase). A significant interaction was observed regarding LVEF, revealing that SBP was not associated with mortality in patients with HFpEF (HRadjusted: 1.01 [0.94-1.09], p = 0.83 per 10 mmHg increase), but SBP was associated with increased mortality in HFrEF (HRadjusted: 0.80 [0.73-0.88], p < 0.001 per 10 mmHg increase) (Figure). Conclusions Elevated SBP is independently associated with favorable short- and long-term outcome in AHF-patients. The association between SBP and mortality was, however, not present in patients with preserved LVEF. Abstract Figure. Survival plots by SBP and LVEF

Download Full-text