Risk Factors for Incident Heart Failure with Preserved or Reduced Ejection Fraction in a Community-Based Cohort

2018 ◽  
Vol 27 ◽  
pp. S127
Author(s):  
F. Gong ◽  
M. Jelinek ◽  
J. Castro ◽  
J. Coller ◽  
M. McGrady ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Community Based ◽  
Reduced Ejection Fraction ◽  
Incident Heart Failure

scholarly journals Risk factors for incident heart failure with preserved or reduced ejection fraction, and valvular heart failure, in a community-based cohort

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000782 ◽  
Author(s):  
Fei Fei Gong ◽  
Michael V Jelinek ◽  
Julian M Castro ◽  
Jennifer M Coller ◽  
Michele McGrady ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Warfarin Therapy ◽  
White Cell Count ◽  
Male Gender ◽  
Community Based ◽  
Reduced Ejection Fraction ◽  
Link Type ◽  
Low Platelet Count

BackgroundThe lack of effective therapies for heart failure with preserved ejection fraction (HFpEF) reflects an incomplete understanding of its pathogenesis.DesignWe analysed baseline risk factors for incident HFpEF, heart failure with reduced ejection fraction (HFrEF) and valvular heart failure (VHF) in a community-based cohort.MethodsWe recruited 2101 men and 1746 women ≥60 years of age with hypertension, diabetes, ischaemic heart disease (IHD), abnormal heart rhythm, cerebrovascular disease or renal impairment. Exclusion criteria were known heart failure, left ventricular ejection fraction <50% or valve abnormality >mild in severity. Median follow-up was 5.6 (IQR 4.6–6.3) years.ResultsMedian time to heart failure diagnosis in 162 participants was 4.5 (IQR 2.7–5.4) years, 73 with HFpEF, 53 with HFrEF and 36 with VHF. Baseline age and amino-terminal pro-B-type natriuretic peptide levels were associated with HFpEF, HFrEF and VHF. Pulse pressure, IHD, waist circumference, obstructive sleep apnoea and pacemaker were associated with HFpEF and HFrEF; atrial fibrillation (AF) and warfarin therapy were associated with HFpEF and VHF and peripheral vascular disease and low platelet count were associated with HFrEF and VHF. Additional risk factors for HFpEF were body mass index (BMI), hypertension, diabetes, renal dysfunction, low haemoglobin, white cell count and β-blocker, statin, loop diuretic, non-steroidal anti-inflammatory and clopidogrel therapies, for HFrEF were male gender and cigarette smoking and for VHF were low diastolic blood pressure and alcohol intake. BMI, diabetes, low haemoglobin, white cell count and warfarin therapy were more strongly associated with HFpEF than HFrEF, whereas male gender and low platelet count were more strongly associated with HFrEF than HFpEF.ConclusionsOur data suggest a major role for BMI, hypertension, diabetes, renal dysfunction, and inflammation in HFpEF pathogenesis; strategies directed to prevention of these risk factors may prevent a sizeable proportion of HFpEF in the community.Trial registration numberNCT00400257, NCT00604006 and NCT01581827.

scholarly journals Relative fat mass, a new index of adiposity, is strongly associated with incident heart failure: data from PREVEND

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Navin Suthahar ◽  
Laura M. G. Meems ◽  
Coenraad Withaar ◽  
Thomas M. Gorter ◽  
Lyanne M. Kieneker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Fat Mass ◽  
Prediction Models ◽  
Age Groups ◽  
Information Criteria ◽  
Anthropometric Indices ◽  
Reduced Ejection Fraction ◽  
Adiposity Indices ◽  
Incident Heart Failure

AbstractBody-mass index (BMI), waist circumference, and waist-hip ratio are commonly used anthropometric indices of adiposity. However, over the past 10 years, several new anthropometric indices were developed, that more accurately correlated with body fat distribution and total fat mass. They include relative fat mass (RFM), body-roundness index (BRI), weight-adjusted-waist index and body-shape index (BSI). In the current study, we included 8295 adults from the PREVEND (Prevention of Renal and Vascular End-Stage Disease) observational cohort (the Netherlands), and sought to examine associations of novel as well as established adiposity indices with incident heart failure (HF). The mean age of study population was 50 ± 13 years, and approximately 50% (n = 4134) were women. Over a 11 year period, 363 HF events occurred, resulting in an overall incidence rate of 3.88 per 1000 person-years. We found that all indices of adiposity (except BSI) were significantly associated with incident HF in the total population (P < 0.001); these associations were not modified by sex (P interaction > 0.1). Amongst adiposity indices, the strongest association was observed with RFM [hazard ratio (HR) 1.67 per 1 SD increase; 95% confidence interval (CI) 1.37–2.04]. This trend persisted across multiple age groups and BMI categories, and across HF subtypes [HR: 1.76, 95% CI 1.26–2.45 for HF with preserved ejection fraction; HR 1.61, 95% CI 1.25–2.06 for HF with reduced ejection fraction]. We also found that all adiposity indices (except BSI) improved the fit of a clinical HF model; improvements were, however, most evident after adding RFM and BRI (reduction in Akaike information criteria: 24.4 and 26.5 respectively). In conclusion, we report that amongst multiple anthropometric indicators of adiposity, RFM displayed the strongest association with HF risk in Dutch community dwellers. Future studies should examine the value of including RFM in HF risk prediction models.

scholarly journals EPIDEMILOGICAL, CLINICAL AND ECHOCARDIOGRAPHIC FEATURES OF HEART FAILURE IN MOROCCO

2021 ◽  
Vol 9 (11) ◽  
pp. 521-526
Author(s):  
A. Maliki Alaoui ◽  
◽  
Y. Fihri ◽  
A. Ben El Mekki ◽  
H. Bouzelmat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Cross Sectional ◽  
Reduced Ejection Fraction ◽  
Cardiology Department ◽  
Common Risk Factors ◽  
The Mean

Heart failure (HF) is a major public issue taking an epidemic dimension globally. Its incidence is continuing to rise because of a growing and aging population. We held a cross-sectional retrospective studyin the cardiology department of Mohamed V military teaching hospital of Rabat in morocco fromSeptember 2019 toSeptember 2021, including 104 patients admitted with HF. The mean age was 68.5 ±10.3year. Hypertension and diabetes mellitus are the most common risk factors. HF with reduced ejection fraction represents about 49%. Forty-four percent had dilated cardiomyopathy. Ischemic heart disease is the first cause of HF.

Abstract 12732: Risk of Heart Failure After Contemporary Radiotherapy for Breast Cancer in the Community

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hirofumi Saiki ◽  
Randi R Finley ◽  
Christopher G Scott ◽  
Elizabeth S Yan ◽  
Ivy A Petersen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Conditional Logistic Regression ◽  
Continuous Variable ◽  
Endothelial Damage ◽  
Myocardial Inflammation ◽  
Reduced Ejection Fraction ◽  
Breast Cancer Radiotherapy

Background: Contemporary breast cancer radiotherapy (RT) results in variable cardiac radiation exposure. While cardiomyocytes are radio-resistant, radiation induces coronary microvascular endothelial damage and inflammation which may ultimately lead to myocardial inflammation, ischemia and fibrosis and put patients at risk for heart failure (HF) and particularly, HF with preserved ejection fraction (HFpEF). Methods: Community based (Olmsted County, MN), HF case-control study of contemporary (1999-2014) breast cancer RT patients with CT-based RT planning for precise mean cardiac radiation dose (MCRD) calculation. HF cases (n=66) and controls (n=129) were matched (1:2) for age at RT, HF risk factors, tumor side and chemotherapy use. Matched controls and cases had identical follow-up (index interval). Proportion of HF and clinical characteristics in categories of MCRD were reported (table) and conditional logistic regression was used to estimate the HF odds ratio (OR) associated with MCRD as a continuous variable. Results: Of the 66 HF cases, 46 (70%) had HFpEF and 20 (30%) had HF with reduced ejection fraction (HFrEF). The proportion of patients with HF (any) or HFpEF increased and proportion with HFrEF tended to increase with increasing MCRD. The prevalence of HF risk factors (hypertension, diabetes, coronary disease) at time of RT did not vary by MCRD while left sided tumor, cancer stage and adriamycin use increased with increasing MCRD. The OR per 1 unit increase in log MCRD was 3.71 (1.98, 6.94) for total HF (p<0.001), 4.91 (1.93, 9.09) for HFpEF (p<0.001) and 2.78 (0.91, 8.47) for HFrEF (p=0.07). The mean index interval was 5.0±3.2 years. Conclusion: Cardiac radiation incident to contemporary breast RT increases the risk of HF, and particularly HFpEF over a short post-RT interval. These data may guide use of proton beam therapy in breast cancer. These data also provide support for the role of coronary microvascular compromise in the pathophysiology of HFpEF.

scholarly journals Incidence and epidemiology of new onset heart failure with preserved vs. reduced ejection fraction in a community-based cohort: 11-year follow-up of PREVEND

2013 ◽  
Vol 34 (19) ◽  
pp. 1424-1431 ◽  
Author(s):  
F. P. Brouwers ◽  
R. A. de Boer ◽  
P. van der Harst ◽  
A. A. Voors ◽  
R. T. Gansevoort ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Community Based ◽  
Reduced Ejection Fraction ◽  
New Onset

scholarly journals Risk factors for heart failure with preserved or reduced ejection fraction among Medicare beneficiaries: Applications of competing risks analysis and gradient boosted model

2019 ◽  
Author(s):  
Moa P. Lee ◽  
Robert J. Glynn ◽  
Sebastian Schneeweiss ◽  
Kueiyu Joshua Lin ◽  
Elisabetta Patorno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
List Type ◽  
Close Monitoring ◽  
Reduced Ejection Fraction

AbstractBackgroundThe differential impact of various demographic characteristics and comorbid conditions on development of heart failure (HF) with preserved (pEF) and reduced ejection fraction (rEF) is not well studied among the elderly.Methods and ResultsUsing Medicare claims data linked to electronic health records, we conducted an observational cohort study of individuals ≥ 65 years of age without HF. A Cox proportional hazards model accounting for competing risk of HFrEF and HFpEF incidence was constructed. A gradient boosted model (GBM) assessed the relative influence (RI) of each predictor in development of HFrEF and HFpEF. Among 138,388 included individuals, 9,701 developed HF (IR= 20.9 per 1,000 person-year). Males were more likely to develop HFrEF than HFpEF (HR = 2.07, 95% CI: 1.81-2.37 vs. 1.11, 95% CI: 1.02-1.20, P for heterogeneity < 0.01). Atrial fibrillation and pulmonary hypertension had stronger associations with the risk of HFpEF (HR = 2.02, 95% CI: 1.80-2.26 and 1.66, 95% CI: 1.23-2.22) while cardiomyopathy and myocardial infarction were more strongly associated with HFrEF (HR = 4.37, 95% CI: 3.21-5.97 and 1.94, 95% CI: 1.23-3.07). Age was the strongest predictor across all HF subtypes with RI from GBM >35%. Atrial fibrillation was the most influential comorbidity for development of HFpEF (RI = 8.4%) while cardiomyopathy was most influential for HFrEF (RI = 20.7%).ConclusionsThese findings of heterogeneous relationships between several important risk factors and heart failure types underline the potential differences in the etiology of HFpEF and HFrEF.Key QuestionsWhat is already known about this subject?Previous epidemiologic studies describe the differences in risk factors involved in developing heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF), however, there has been no large study in an elderly population.What does this study add?This study provides further insights into the heterogeneous impact of various clinical characteristics on the risk of developing HFpEF and HFrEF in a population of elderly individuals.Employing an advanced machine learning technique allows assessing the relative importance of each risk factor on development of HFpEF and HFrEF.How might this impact on clinical practice?Our findings provide further insights into the potential differences in the etiology of HFpEF and HFrEF, which are critical in prioritizing populations for close monitoring and targeting prevention efforts.

Abstract P169: Difference of Risk Factors for Controlled Blood Pressure in Three Types of Heart Failure

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Hong Seok Lee ◽  
Nunez Belen ◽  
Hans Cativo ◽  
Amrut Savadkar ◽  
Visco Ferdinand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Ventricular Hypertrophy ◽  
Multiple Logistic Regression Analysis ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Different Types ◽  
Artery Disease ◽  
The Relationship

Background: Hypertension is the most important modifiable risk factor for worsening heart failure (HF) because hypertension increases cardiac work, which results in worsening left ventricular hypertrophy and development of coronary artery disease. We will determine risk fctors of BP control in different types of heart failure according to JNC 8 guideline. Method: Based on ACC/AHA guidelines, heart failure is classified as a reduced ejection fraction(HFrEF, EF <40), preserved ejection fraction (HFpEF, EF>50) and heart failure with an improved ejection fraction(HFpEF(i),EF≥40). 732 patients enrolled in our heart failure program were analyzed retrospectively. And 672 patients who had been followed from Jan 1 st ,2013 to June 30st 2015 were included. Multiple logistic regression analysis was performed to determine the relationship between hypertension and heart failure after adjusting for potential confounders. Results: Patients with three types of heart failure had different BP control rate. It was 67.5% (308/456) ,76.5%(104/136), 77.5%(62/80) in HFrEF, HFrEF, and HFpEF(i) based on JNC 8 guideline, respectively. Mean systolic BP was 127.1±17 mmHg in HFrEF, 129.0±21 mmHg in HFpEF and 124.4±18 mmHg in HFpEF(i). Obesity [Odds ratio (OR): 0.12,95% Confidence Interval(CI): 0.048-0.284] , ACE inhibitor or ARB [OR: 2.66, CI: 1.50-3.42] and lasix [OR: 1.90,CI: 1.07-3.40] and aspirin [OR 0.53, CI: 0.37-0.96] were noted to be related to controlled BP in HFrEF. Aspirin [OR 0.17, CI: 0.05-0.60] was significantly associated with controlled BP in HFpEF. And beta-blocker [OR: 0.07, CI: 0.01-0.62] and anti-lipid medication [OR: 4.76, CI: 1.73-5.89] were associated with BP control in HFpEF(i). Conclusion: In each type of heart failure, there was difference of risk factors related to BP control. Different medications were associated with control of BP in different types of heart failure. Patients may need to modify risk factors including types of medication to control BP according to types of heart failure. It might be leading to better heart failure management.

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