Abstract 16683: Reduced Lung Function is Associated With Decreased Ejection Fraction and Decreased Left Ventricular Size in Patients in a Tertiary Care Center

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Melissa S Burroughs Pena ◽  
Michael Durheim ◽  
Phillip Schulte ◽  
Peter Kussin ◽  
William Checkley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Lung Function ◽  
Ejection Fraction ◽  
Pulmonary Disease ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Size ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Size ◽  
Age And Sex

Background: Pulmonary disease has been associated with poor cardiovascular outcomes including heart failure; yet, the relationship between measures of obstructive and restrictive lung disease as defined on pulmonary function testing (PFT) and left ventricular size and function remains unknown. The objective of this study is to determine the correlation between forced expiratory volume/1 sec (FEV1), forced vital capacity (FVC) and FEV1/FVC with left ventricular ejection fraction (LVEF), internal diastolic diameter (LVIDD), and internal systolic dimension (LVISD) as measured by transthoracic echocardiography (TTE). Methods: We selected patients who underwent both TTE and PFT within 7 days from January 2012 to April 2013. We examined for bivariate relationships by using Pearson’s correlation coefficient to determine associations between pre-bronchodilator FEV1, FVC and FEV1/FVC and the following TTE measures: LVEF,LVIDD, and LVISD. Multivariable regression analysis was used to adjust for age and sex. Results: We identified 2238 patients who had TTE and PFT within 7 days. After adjusting for age and sex, FEV1, FVC, and FEV1/FVC were positively correlated with LVEF and LVIDD. Every 100 cc reduction in FVC or 90 cc reduction in FEV1 was associated with a 5% decrease in LVEF (95% CI 0.079- 0.128, 0.068- 0.109). Moreover, a 200 cc reduction in FEV1 or 220 cc reduction in FVC was associated with a 1 cm decrease in LVIDD (95% CI 0.152- 0.247, 0.165- 0.282,). These correlations remained significant when percent predicted instead of absolute FEV1 and FVC were evaluated. Conclusion: Abnormal lung function is associated with reduced LV function without corresponding increases in ventricular size. These findings suggest that the association between pulmonary disease and heart failure may not depend on adverse ventricular remodeling and requires further study.

scholarly journals Left Ventricular Size and Outcomes in Patients With Left Ventricular Ejection Fraction Less Than 20%

2020 ◽  
Vol 110 (3) ◽  
pp. 863-869 ◽  
Author(s):  
Naoto Fukunaga ◽  
Roberto Vanin Pinto Ribeiro ◽  
Myriam Lafreniere-Roula ◽  
Cedric Manlhiot ◽  
Mitesh V. Badiwala ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Size ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Size

scholarly journals Electroanatomic Ratios and Mortality in Patients With Heart Failure: Insights from the ASIAN‐HF Registry

2021 ◽  
Author(s):  
Janice Y. Chyou ◽  
Wan Ting Tay ◽  
Inder S. Anand ◽  
Tiew‐Hwa Katherine Teng ◽  
Jonathan J. L. Yap ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Size ◽  
Reduced Ejection Fraction ◽  
Left Ventricular Size ◽  
All Cause Mortality

Background QRS duration (QRSd) is a marker of electrical remodeling in heart failure. Anthropometrics and left ventricular size may influence QRSd and, in turn, may influence the association between QRSd and heart failure outcomes. Methods and Results Using the prospective, multicenter, multinational ASIAN‐HF (Asian Sudden Cardiac Death in Heart Failure) registry, this study evaluated whether electroanatomic ratios (QRSd indexed for height or left ventricular end‐diastole volume) are associated with 1‐year mortality in individuals with heart failure with reduced ejection fraction. The study included 4899 individuals (aged 60±19 years, 78% male, mean left ventricular ejection fraction: 27.3±7.1%). In the overall cohort, QRSd was not associated with all‐cause mortality (hazard ratio [HR], 1.003; 95% CI, 0.999–1.006, P =0.142) or sudden cardiac death (HR, 1.006; 95% CI, 1.000–1.013, P =0.059). QRS/height was associated with all‐cause mortality (HR, 1.165; 95% CI, 1.046–1.296, P =0.005 with interaction by sex p interaction =0.020) and sudden cardiac death (HR, 1.270; 95% CI, 1.021–1.580, P =0.032). QRS/left ventricular end‐diastole volume was associated with all‐cause mortality (HR, 1.22; 95% CI, 1.05–1.43, P =0.011) and sudden cardiac death (HR, 1.461; 95% CI, 1.090–1.957, P =0.011) in patients with nonischemic cardiomyopathy but not in patients with ischemic cardiomyopathy (all‐cause mortality: HR, 0.94; 95% CI, 0.79–1.11, P =0.467; sudden cardiac death: HR, 0.734; 95% CI, 0.477–1.132, P =0.162). Conclusions Electroanatomic ratios of QRSd indexed for body size or left ventricular size are associated with mortality in individuals with heart failure with reduced ejection fraction. In particular, increased QRS/height may be a marker of high risk in individuals with heart failure with reduced ejection fraction, and QRS/left ventricular end‐diastole volume may further risk stratify individuals with nonischemic heart failure with reduced ejection fraction. Registration URL: https://Clinicaltrials.gov . Unique identifier: NCT01633398.

Abstract 14990: Sudden Death in Patients with Heart Failure and Preserved Ejection Fraction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kyndaron Reinier ◽  
Audrey Uy-Evanado ◽  
Carmen Teodorescu ◽  
Eloi Marijon ◽  
Kumar Narayanan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Clinical History ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Preserved Ejection Fraction ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
History Of ◽  
Age And Sex

Introduction: Severely reduced left ventricular ejection fraction (EF) is an established risk factor for sudden cardiac death (SCD), but has limited sensitivity and specificity. We evaluated the contribution of heart failure (HF) with preserved ejection fraction toward risk of SCD in the general population. Hypothesis: We hypothesized that HF would predict risk of SCD, even among patients with preserved EF. Methods: Subjects from an ongoing community-based study of SCD in the northwest US (pop. approx. one million) were included if age ≥18 (2002 - 2012) with clinical history and assessment of EF. Clinical history of heart failure (HF) was determined by physician report. Ejection fraction (EF) was determined from echocardiogram, angiogram, or multigated acquisition scan, and categorized as EF <20%, 20-34%, 35-44%, 45-54%, and ≥55%. Laboratory values of brain natriuretic peptide (BNP) were obtained from routine clinical laboratory testing for a subset of patients. Results: Cases (n=628, mean age 69.9, 65% male) were more likely than controls (n = 580, mean age 66.8, 66% male) to have a history of clinically-recognized HF (58% vs. 24%, p<0.0001) and to have an EF ≤ 35% (27% vs. 12%, p<0.0001). At each EF level above 20%, HF was approximately twice as prevalent in cases compared to controls (Figure, p≤0.002). Median BNP levels were significantly higher for patients with HF vs. those without, across EF categories. Adjusting for age and sex, each category of decreasing EF was associated with an increased risk of SCD (OR 1.4, 95% CI 1.3 - 1.6, p<0.0001), but the association was diminished by adjustment for HF, and for BNP. Odds of SCD were 4-fold higher (p<0.0001) in the presence HF, adjusting for age and sex, across all categories of EF. Conclusions: In this population, the significant role of HF with preserved EF in SCD was confirmed by BNP level trends. Improvements in SCD prevention will require focused investigation of high risk SCD markers in patients with heart failure and preserved EF.

Heart Failure with Preserved Ejection Fraction – A Review

2012 ◽  
Vol 9 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Otto A Smiseth ◽  
Anders Opdahl ◽  
Espen Boe ◽  
Helge Skulstad
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Heart Failure ◽  
The Elderly ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
Objective Evidence

Heart failure with preserved left ventricular ejection fraction (HF-PEF), sometimes named diastolic heart failure, is a common condition most frequently seen in the elderly and is associated with arterial hypertension and left ventricular (LV) hypertrophy. Symptoms are attributed to a stiff left ventricle with compensatory elevation of filling pressure and reduced ability to increase stroke volume by the Frank-Starling mechanism. LV interaction with stiff arteries aggravates these problems. Prognosis is almost as severe as for heart failure with reduced ejection fraction (HF-REF), in part reflecting co-morbidities. Before the diagnosis of HF-PEF is made, non-cardiac etiologies must be excluded. Due to the non-specific nature of heart failure symptoms, it is essential to search for objective evidence of diastolic dysfunction which, in the absence of invasive data, is done by echocardiography and demonstration of signs of elevated LV filling pressure, impaired LV relaxation, or increased LV diastolic stiffness. Antihypertensive treatment can effectively prevent HF-PEF. Treatment of HF-PEF is symptomatic, with similar drugs as in HF-REF.

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