Abstract P023: Risk Factors Associated with Progression of Subclinical Diastolic Dysfunction in a Multiethnic Population

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lili Zhang ◽  
Jian Shan ◽  
Cynthia Taub
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Diastolic Dysfunction ◽  
Significant Risk ◽  
Left Ventricular ◽  
Cumulative Probability ◽  
Factors Associated ◽  
Hispanic Patients ◽  
Multiethnic Population

Background: Subclinical diastolic dysfunction is defined as echocardiographic evidence of left ventricular diastolic dysfunction and normal ejection fraction (EF) without congestive heart failure (HF) symptoms/diagnosis. Our study, for the first time, sought to examine risk factors associated with progression from subclinical diastolic dysfunction to overt HF in a large multiethnic population. Methods: The study population included patients with asymptomatic diastolic dysfunction and EF ≥ 50% assessed by transthoracic echocardiogram between 2003 and 2008 at Montefiore Medical Center, Bronx, NY. Patients with preexisting HF, valvular heart disease or atrial fibrillation prior were excluded. The end point was the development of HF by September 1, 2013. Multivariable adjusted Cox proportional hazards models, determined by stepwise selection method, were performed to examine risk factors associated with the development of HF. All analyses were also performed with adjustment and stratification of race. Results: A total of 7,879 patients, with 21% European Americans (EA), 36% African Americans (AA), 31% Hispanics, and 12% others or unknown, were included in the analysis. Mean follow up time was 6.3 years. Mean age of the cohort was 68±12, with 63% women. The overall cumulative probability of development of HF was 17% (19% in EA, 17% in AA, 19% in Hispanic patients) during the follow up period. In multivariable Cox proportional hazard regression analysis, renal disease (hazard ratio (HR)=1.6, 95% confidence interval (CI) 1.3-2.0, P<0.001) and hemoglobin levels (HR=0.9, 95% CI 0.9-1.0, P=0.001) were significantly associated with the development of HF in overall population. In stratification analysis, age (P=0.012) and hypertension (P=0.007) were independent risk factors for HF in Hispanic patients, but not in EA and AA. Conclusions: In a large multiethnic population with subclinical diastolic dysfunction, renal disease and hemoglobin levels were independently associated with development of HF in overall population.. Age and hypertension were significant risk factors for HF only in Hispanic patients. These results may have important implications in preventing the development of HF from subclinical stage.

scholarly journals Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Claudia Loardi ◽  
Francesco Alamanni ◽  
Claudia Galli ◽  
Moreno Naliato ◽  
Fabrizio Veglia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Left Ventricular ◽  
Maze Procedure ◽  
Right Atrial ◽  
Lv Function ◽  
Factors Associated ◽  
Procedural Success ◽  
Cox Analysis

Background. Maze procedure aims at restoring sinus rhythm (SR) and atrial contractility (AC). This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation.Methods. 122 mitral and fibrillating patients underwent radiofrequency Maze. Rhythm check and echocardiographic control of biatrial contractility were performed at 3, 6, 12, and 24 months postoperatively. A multivariate Cox analysis of risk factors for absence of AC recuperation was applied.Results. At 2-years follow-up, SR was achieved in 79% of patients. SR-AC coexistence increased from 76% until 98%, while biatrial contraction detection augmented from 84 to 98% at late stage. Shorter preoperative arrhythmia duration was the only common predictor of SR-AC restoring, while pulmonary artery pressure (PAP) negatively influenced AC recuperation. Early AC restoration favored future freedom from arrhythmia recurrence. Minor LA dimensions correlated with improved future A/E value and vice versa. Right atrial (RA) contractility restoring favored better left ventricular (LV) performance and volumes.Conclusions. SR and left AC are two interrelated Maze objectives. Factors associated with arrhythmia “chronic state” (PAP and arrhythmia duration) are negative predictors of procedural success. Our results suggest an association between postoperative LA dimensions and “kick” restoring and an influence of RA contraction onto LV function.

Alterations to cardiac morphology and function among high-altitude workers: a retrospective cohort study

2020 ◽  
Vol 77 (7) ◽  
pp. 447-453
Author(s):  
Shurong Han ◽  
Lin Zhao ◽  
Shiwei Ma ◽  
Zhangjian Chen ◽  
Shiping Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Altitude ◽  
Retrospective Cohort ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Factors Associated ◽  
Cardiac Abnormalities ◽  
Ventricular Diastolic Dysfunction ◽  
And Function

ObjectivesExposure to high altitude can affect human health, including the development of adverse cardiovascular effects. This study aimed to investigate alterations in cardiac morphology and function in high-altitude workers and to identify risk factors associated with cardiac abnormalities.MethodsA retrospective cohort study was conducted with 286 Qinghai-Tibetan Railroad maintenance workers. Participant data were collected from company personnel records. Data on echocardiography and diagnosis of cardiac abnormalities were extracted from participants’ medical records. Time-to-event analysis was used to investigate the risk of cardiac abnormalities among participants with different baseline characteristics and identify risk factors associated with cardiac abnormalities that developed as a result of working at high altitude.ResultsA total of 173 participants had developed cardiac abnormalities during the follow-up period. The most common cardiac abnormality was right atrial enlargement, followed by left ventricular diastolic dysfunction and tricuspid regurgitation. Among participants with cardiac abnormalities, the median follow-up time was 17 months. Compared with participants who were younger than 20 years and working at altitude <4000 m, participants older at employment and working at extremely high altitude were more likely to develop cardiac abnormalities. Nearly 40% of the participants who worked at altitude <4000 m remained without cardiac abnormalities during the follow-up period.ConclusionsOver 60% of participants developed cardiac abnormalities after working at high altitude, predominantly right heart enlargement and left ventricular diastolic dysfunction. Age at employment and workplace altitude were significant risk factors for cardiac abnormalities. Enhanced regular physical examinations are recommended for high-altitude workers.

scholarly journals Risk Factors Associated with Left Ventricular Diastolic Dysfunction in Type 2 Diabetic Patients without Hypertension

2010 ◽  
Vol 34 (1) ◽  
pp. 40 ◽  
Author(s):  
Jung Hyun Noh ◽  
Joon Hyung Doh ◽  
Sung Yun Lee ◽  
Tae Nyun Kim ◽  
Hyuk Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Factors Associated ◽  
Ventricular Diastolic Dysfunction ◽  
Type 2 Diabetic

scholarly journals Post phototherapy bilirubin rebound: incidence and risk factors

2017 ◽  
Vol 5 (9) ◽  
pp. 4112
Author(s):  
Richa Soni ◽  
Shayam L. Kaushik ◽  
Rajni Kaushik ◽  
Parveen Bhardwaj ◽  
S. Mohabey
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
American Academy ◽  
G6pd Deficiency ◽  
Significant Risk ◽  
Factors Associated ◽  
American Academy Of Pediatrics ◽  
Rh Incompatibility ◽  
Associated Risk Factors

Background: Rebound hyperbilirubinemia may occur after cessation of phototherapy in new-borns in certain high-risk situations. However, data regarding the phenomenon of bilirubin rebound is lacking from India. Aim was to study the incidence and associated risk factors of post phototherapy rebound hyperbilirubinemia.Methods: The study subjects included all neonates (gestation >34 weeks) admitted to newborn unit who required phototherapy for hyperbilirubinemia. Unit protocol based on American academy of pediatrics (AAP) guidelines were used to start and stop phototherapy. Rebound bilirubin was measured 24±6 hours after stopping phototherapy. Significant bilirubin rebound (SBR) was defined as post phototherapy bilirubin level needing reinstitution of phototherapy. The risk factors associated with significant rebound were studied.Results: Out of total 509 neonates who received phototherapy due to hyperbilirubinemia, 63 (12%) had significant bilirubin rebound requiring reinstitution of phototherapy. There was significant risk for rebound in neonates who had prematurity (p <0.01), ABO (<0.001) and Rh incompatibility (p<0.005) with mother, G6PD deficiency (p < 0.001) and onset of hyperbilirubinemia less than 72 hours of postnatal age (p< 0.001). However, neonates with extravasations of blood, polycythaemia, sepsis, other causes of haemolysis and idiopathic group did not have significant risk of developing rebound.Conclusions: Post phototherapy bilirubin estimation and follow up should be ensured in high-risk neonates.

Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

2015 ◽  
Vol 18 (1) ◽  
pp. 006
Author(s):  
Hasan Reyhanoglu ◽  
Kaan Ozcan ◽  
Murat Erturk ◽  
Fatih İslamoglu ◽  
İsa Durmaz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Significant Risk ◽  
High Morbidity ◽  
Factors Associated

<strong>Objective:</strong> We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery.<br /><strong>Methods:</strong> One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group <br />(C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated.<br /><strong>Results:</strong> Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while <br />26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P &lt; .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively.<br /><strong>Conclusion:</strong> Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.<br /><br />

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction

2021 ◽  
pp. 1-11
Author(s):  
Yini Wang ◽  
Xueqin Gao ◽  
Zhenjuan Zhao ◽  
Ling Li ◽  
Guojie Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Significant Risk ◽  
Type D Personality ◽  
Adverse Outcomes ◽  
Combined Effect ◽  
Continuous Variables ◽  
Type D

Abstract Background Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). Methods This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. Results A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. Conclusions These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

scholarly journals An Exploration of Heart Failure Risk in Breast Cancer Patients Receiving Anthracyclines with or without Trastuzumab in Thailand: A Retrospective Study

2021 ◽  
Vol 11 (3) ◽  
pp. 484-493
Author(s):  
Jukapun Yoodee ◽  
Aumkhae Sookprasert ◽  
Phitjira Sanguanboonyaphong ◽  
Suthan Chanthawong ◽  
Manit Seateaw ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Breast Cancer Patients ◽  
Ventricular Ejection Fraction ◽  
Factors Associated ◽  
Palliative Intent ◽  
Increased Risk

Anthracycline-based regimens with or without anti-human epidermal growth factor receptor (HER) 2 agents such as trastuzumab are effective in breast cancer treatment. Nevertheless, heart failure (HF) has become a significant side effect of these regimens. This study aimed to investigate the incidence and factors associated with HF in breast cancer patients treated with anthracyclines with or without trastuzumab. A retrospective cohort study was performed in patients with breast cancer who were treated with anthracyclines with or without trastuzumab between 1 January 2014 and 31 December 2018. The primary outcome was the incidence of HF. The secondary outcome was the risk factors associated with HF by using the univariable and multivariable cox-proportional hazard model. A total of 475 breast cancer patients were enrolled with a median follow-up time of 2.88 years (interquartile range (IQR), 1.59–3.93). The incidence of HF was 3.2%, corresponding to an incidence rate of 11.1 per 1000 person-years. The increased risk of HF was seen in patients receiving a combination of anthracycline and trastuzumab therapy, patients treated with radiotherapy or palliative-intent chemotherapy, and baseline left ventricular ejection fraction <65%, respectively. There were no statistically significant differences in other risk factors for HF, such as age, cardiovascular comorbidities, and cumulative doxorubicin dose. In conclusion, the incidence of HF was consistently high in patients receiving combination anthracyclines trastuzumab regimens. A reduced baseline left ventricular ejection fraction, radiotherapy, and palliative-intent chemotherapy were associated with an increased risk of HF. Intensive cardiac monitoring in breast cancer patients with an increased risk of HF should be advised to prevent undesired cardiac outcomes.

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