The relationship between mitral regurgitation and ejection fraction as predictors for the prognosis of patients with heart failure

2011 ◽  
Vol 13 (10) ◽  
pp. 1121-1125 ◽  
Author(s):  
Redi Pecini ◽  
Jens Jakob Thune ◽  
Christian Torp-Pedersen ◽  
Christian Hassager ◽  
Lars Køber
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Relationship

Association of Hyper-Polypharmacy With Clinical Outcomes in Heart Failure With Preserved Ejection Fraction

2021 ◽  
Author(s):  
Masatoshi Minamisawa ◽  
Brian Claggett ◽  
Kota Suzuki ◽  
Sheila M. Hegde ◽  
Amil M. Shah ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Ejection Fraction ◽  
Primary Outcome ◽  
Hazard Ratio ◽  
Preserved Ejection Fraction ◽  
Serious Adverse Events ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
The Relationship

Background: Polypharmacy is associated with a poor prognosis in the elderly, however, information on the association of polypharmacy with cardiovascular outcomes in heart failure with preserved ejection fraction is sparse. This study sought to investigate the relationship between polypharmacy and adverse cardiovascular events in patients with heart failure with preserved ejection fraction. Methods: Baseline total number of medications was determined in 1758 patients with heart failure with preserved ejection fraction enrolled in the Americas regions of the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist), by 3 categories: nonpolypharmacy (<5 medications), polypharmacy (5–9), and hyper-polypharmacy (≥10). We examined the relationship of polypharmacy status with the primary outcome (cardiovascular death, HF hospitalization, or aborted cardiac arrest), hospitalizations for any reason, and serious adverse events. Results: The proportion of patients taking 5 or more medications was 92.5% (inclusive of polypharmacy [38.7%] and hyper-polypharmacy [53.8%]). Over a 2.9-year median follow-up, compared with patients with polypharmacy, hyper-polypharmacy was associated with an increased risk for the primary outcome, hospitalization for any reason and any serious adverse events in the univariable analysis, but not significantly associated with mortality. After multivariable adjustment for demographic and comorbidities, hyper-polypharmacy remained significantly associated with an increased risk for hospitalization for any reason (hazard ratio, 1.22 [95% CI, 1.05–1.41]; P =0.009) and any serious adverse events (hazard ratio, 1.23 [95% CI, 1.07–1.42]; P =0.005), whereas the primary outcome was no longer statistically significant. Conclusions: Hyper-polypharmacy was common and associated with an elevated risk of hospitalization for any reason and any serious adverse events in patients with heart failure with preserved ejection fraction. There were no significant associations between polypharmacy status and mortality.

Prognostic Implications of Functional Mitral Regurgitation in Patients With Heart Failure and Reduced Ejection Fraction

2017 ◽  
Vol 70 (9) ◽  
pp. 785-787
Author(s):  
M. Dolores García-Cosío Carmena ◽  
Eulalia Roig Minguell ◽  
Andreu Ferrero-Gregori ◽  
Rafael Vázquez García ◽  
Juan Delgado Jiménez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Ejection Fraction ◽  
Functional Mitral Regurgitation ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Prognostic Implications

scholarly journals The Relationship between Abnormal Circadian Blood Pressure Rhythm and Risk of Readmission in Patients with Heart Failure with Preserved Ejection Fraction

2021 ◽  
Author(s):  
Jianlin Du,
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Risk Factor ◽  
Ejection Fraction ◽  
Circadian Blood Pressure ◽  
Patients With Heart Failure ◽  
The Mean ◽  
The Relationship ◽  
Pattern Group ◽  
Readmission Risk

Objective: Abnormal circadian blood pressure rhythm has been revealed to be associated with hypertensive targetorgan damage and cardiovascular events, but its association with readmission risk in patients with heart failure with preserved ejection fraction (HFpEF) remains unknown. We conducted a retrospective study to explore the relationship between circadian blood pressure rhythm and readmission risk in HFpEF patients.Methods: We retrospectively collected baseline and follow-up data on HFpEF patients who underwent ambulatory blood pressure monitoring (ABPM) from May 2015 to October 2019. Patient circadian blood pressure rhythms defined by ABPM were grouped as dipper, nondipper, or riser patterns. Univariate and multivariate linear regression analyses were performed to assess the association between circadian blood pressure rhythm and readmission risk.Results: A total of 122 patients were enrolled in this study. The mean age and ejection fraction were 69.87 years and61.44%, respectively, with mean the N-terminal pro-B-type natriuretic peptide (NT-proBNP) level being 1048.15 pg/mL.There were significant differences in the 24-hour systolic blood pressure (SBP), sleep SBP, and sleep diastolic blood pressure (DBP) among the three groups, where the 24-hour SBP, sleep SBP, and sleep DBP in the riser pattern group were markedly higher than in the dipper pattern group. Notably, serum NT-proBNP levels, the proportion of patients readmitted for heart failure and the mean number of admissions differed markedly among three groups. Instructively, multivariate linear regression analysis showed that the riser pattern was a significant and independent risk factor for increased serum NT-proBNP level (β = 929.16, 95% confidence interval 178.79–1679.53, P = 0.016). In multivariatelogistic regression analysis, the riser pattern was demonstrated to be a significant risk factor for readmission (odds ratio11.23, 95% confidence interval 2.01–62.67, P = 0.006) in HFpEF patients.Conclusion: The riser blood pressure pattern is a potential risk factor for elevated serum NT-proBNP level and readmissionin HFpEF patients.

The prognostic value of myocardial deformational patterns is reduced in patients with heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Holm ◽  
P Brainin ◽  
M Sengeloev ◽  
P.G Joergensen ◽  
N.E Bruun ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
The Relationship ◽  
Maximal Strain

Abstract Background Early systolic lengthening (ESL) and postsystolic shortening are considered highly specific for myocardial ischemia. We aimed to investigate the prognostic potential of both deformational patterns in patients with heart failure (HF) and to determine if a history of ischemic heart disease modified this relationship. Method A total of 884 patients with systolic HF (66±12 years, male 73%, mean ejection fraction 28±9%) underwent speckle tracking echocardiography. Of these, 61% suffered from ischemic cardiomyopathy (ICM). Patients were followed for all-cause mortality. We assessed the ESL index: [−100x (peak positive strain/maximal strain)] and the postsystolic index (PSI): [100x (postsystolic strain/maximal strain)]. Both parameters were averaged across 18 myocardial segments. Results During a median follow-up of 3.4 years [interquartile range 1.9 to 4.8], 132 patients (15%) died. In multivariable survival analyses adjusted for potential confounders (age, sex, BMI, mean arterial pressure, cholesterol, heart rate, CABG/PCI, left ventricular ejection fraction and mass index, left atrial volume index, tricuspid annular plane systolic excursion, E-wave, E/e', deceleration time, and global longitudinal strain) neither the ESL index (HR 1.02 per 1% increase [0.97 to 1.08], P=0.40) nor PSI (HR 1.00 per 1% increase [0.98 to 1.01], P=0.69) were associated with all-cause mortality. ICM modified the relationship (P interaction unadjusted/adjusted=0.001/0.008; Figure) such that per 1% increase in ESL index in patients with ICM was significantly associated with all-cause mortality (unadjusted: HR 1.09 [1.04 to 1.15], P&lt;0.001 and adjusted: HR 1.06 [1.00 to 1.13], P=0.045) but not in those without (unadjusted: HR 1.02 [1.01 to 1.03], P=0.002 and adjusted: HR 0.99 [0.90 to 1.09], P=0.086). ICM did not modify the relationship between PSI and all-cause mortality (P interaction unadjusted/adjusted=0.15/0.13). Conclusion Our results indicate that in this cohort of undifferentiated HF patients with reduced ejection fraction the prognostic value of deformational patterns was reduced. However, the ESL index may provide some information on prognosis in patients with ICM. ESL and interaction with ICM Funding Acknowledgement Type of funding source: None

scholarly journals Resting Heart Rate and Ischemic Stroke in Patients with Heart Failure

2017 ◽  
Vol 44 (1-2) ◽  
pp. 43-50
Author(s):  
Koki Nakanishi ◽  
Marco R. Di Tullio ◽  
Min Qian ◽  
John L.P. Thompson ◽  
Arthur J. Labovitz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Ischemic Stroke ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Systolic Heart Failure ◽  
Resting Heart Rate ◽  
Patients With Heart Failure ◽  
The Relationship

Background: Although high resting heart rate (RHR) is known to be associated with an increased risk of mortality and hospital admission in patients with heart failure, the relationship between RHR and ischemic stroke remains unclear. This study is aimed at investigating the relationship between RHR and ischemic stroke in patients with heart failure in sinus rhythm. Methods: We examined 2,060 patients with systolic heart failure in sinus rhythm from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial. RHR was determined from baseline electrocardiogram, and was examined as both a continuous variable and a categorical variable using quartiles. Ischemic strokes were identified during follow-up and adjudicated by physician review. Results: During 3.5 ± 1.8 years of follow-up, 77 patients (5.3% from Kaplan-Meier [KM] curve) experienced an ischemic stroke. The highest incidence of ischemic stroke (21/503 [KM 6.9%]) was observed in the lowest RHR quartile (RHR <64 beats/min) compared to other groups; 22/573 (KM 5.3%) in 64-70 beats/min, 13/465 (KM 3.5%) in 71-79 beats/min, and 21/519 (KM 5.4%) in RHR >79 beats/min (p = 0.693). Multivariable Cox proportional hazards analysis revealed that RHR was significantly associated with ischemic stroke (hazard ratio per unit decrease: 1.07, 95% CI 1.02-1.13, when RHR <64/beats/min; p = 0.038), along with a history of stroke or transient ischemic attack and left ventricular ejection fraction. Conclusions: In contrast to its beneficial effect on mortality and hospital re-admissions, lower RHR may increase the risk of ischemic stroke in patients with systolic heart failure in sinus rhythm.

The relationship between clinical parameters and natriuretic peptides and quality of life in patients with heart failure with reduced ejection fraction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Sawczak ◽  
A Kukfisz ◽  
K Przytarska ◽  
M Szczechla ◽  
H Krysztofiak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Ejection Fraction ◽  
Natriuretic Peptides ◽  
Nyha Class ◽  
Clinical Parameters ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Heart failure (HF) patients are exposed to severe symptoms of the disease, fatal prognosis, rehospitalizations and low quality of life status. Furthermore, it was observed that more patients with HF would rather live better than longer. Purpose The aim of the study was to determine the relationship between clinical parameters, natriuretic peptides level and quality of life (QoL) in patients with heart failure with reduced ejection fraction. Methods 111 patients hospitalized due to heart failure with reduced ejection fraction (HFrEF) were examined using WHOQOL-BREF questionnaire and divided into three groups of similar quantity due to their transformed score of somatic domain of QoL: first group with score &lt;45 - worst QoL (n = 33), second group with score between 45 and 55 (n = 42), and third with score &gt;55 - best QoL (n = 36). Then the group with highest scores, with best somatic QoL, was compared with those with lowest scores in respect of chosen clinical and biochemical parameters. Results Patients with the highest somatic domain score, comparing with the lowest, had significantly higher BMI (mean 29.8 ± 5.5 vs. 26.8 ± 5.7 kg/m2, p = 0.016), lower BNP level (465 vs. 967 pg/ml, median 275 vs. 690, p =0.005), higher LVEF (30.7 ± 12.0 vs. 23.9 ± 10.8%, p = 0.006), higher triglycerides level (2.02 ± 1.22 vs. 1.43 ± 0.76 mmol/l, p = 0.027) and iron level (17.8 ± 6.6 vs. 13.6 ± 5.5 µmol/l, p = 0.019) as well as transferrin saturation (28.0 ± 11.0 vs. 21.3 ± 8.9 %, p = 0.015). The percentage of patients with NYHA class I and II was higher in the group with the highest somatic domain score in comparison with the lowest (66.6% vs. 33.3% respectively, p = 0.034). Conclusions The somatic domain of WHOQOL-BREF in patients with HFrEF correlates with patients’ clinical state assessed with the NYHA class and BNP level. QoL status was not associated with age and gender which are depicted in the literature as the important aspects influencing QoL of the community.

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