scholarly journals Anxiety level in pregnant women in the first year of COVID-19 pandemic

2021 ◽  
Vol 10 (10) ◽  
pp. 3670
Author(s):  
Esra Tamburaci
Keyword(s):  
Pregnant Women ◽  
Psychosocial Support ◽  
Linear Regression Analysis ◽  
Anxiety Level ◽  
Fear Of Death ◽  
Mental Wellbeing ◽  
Health Concern ◽  
First Year ◽  
Multivariate Linear Regression Analysis

Background: The study was aimed to determine the effect of the ongoing infection on the anxiety level of pregnant women during the first year of the COVID-19 pandemic.Methods: In this study, a structured questionnaire and the Beck anxiety inventory were administered to pregnant women who volunteered to participate in the research among the ones who applied to the outpatient clinic for routine prenatal care from January 2021-March 2021.Results: The study featured 200 pregnant women with a mean age of 28.3±6.8 years and a range of 18-45 years. The patients were divided into four groups according to their Beck score as minimal (38.5%), mild (42%), moderate (15.5%), and severe (4%) levels of anxiety. Women with moderate and severe levels of anxiety were observed to have higher rates of fear of getting infected with COVID-19, fear of infecting the baby, fear of death due to COVID-19, fear of losing her relative due to COVID-19, fear of losing her baby due to COVID-19, and fear of quarantine (p<0.001). Factors that independently affected the level of anxiety in pregnant women were examined by multivariate linear regression analysis. It was found that increasing age (β=0.246; p<0.001), fear of getting infected with COVID-19 (β=0.375; p<0.001), fear of death due to COVID-19 (β=0.105; p=0.044) and fear of losing her baby due to COVID-19 (β=0.205; p<0.001) positively associated with anxiety levels.Conclusions: Because of the detrimental impact on both the mother and the infant, perinatal mental wellbeing is a major public health concern. Thus, aside from the follow-up of pregnant women by a multidisciplinary team of perinatology, neonatology, and intensive care specialists, it is essential to provide psychosocial support during the pandemic.

P1399SPARING EFFECT OF PERITONEAL DIALYSIS VS HEMODIALYSIS ON CHANGE OF BONE MINERAL DENSITY EVALUATED BY WHOLE-BODY DXA AFTER INITIATION OF DIALYSIS THERAPY AND ITS IMPACT ON CLINICAL OUTCOME

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ken Iseri ◽  
Longkai Li ◽  
Abdul Rashid Tony Qureshi ◽  
Xin Li ◽  
Jonaz Ripsweden ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Whole Body ◽  
First Year ◽  
Multivariate Linear Regression Analysis ◽  
Mineral Density ◽  
Initiation Of Dialysis ◽  
One Year ◽  
Esrd Patients ◽  
Cvd Mortality

Abstract Background and Aims Bone loss is associated with progression of cardiac calcification and increased mortality in end stage renal disease (ESRD) patients but the relations and underlying causes are unclear. We investigated factors associated with changes of bone mineral density (BMD) during the first year after initiation of dialysis and the association between BMD changes and subsequent mortality in ESRD patients. Method In a prospective study of 242 ESRD patients (median age 55 years, 61% men) starting dialysis, total BMD and BMD at specific bone sites (including seven subregions: head, arms, legs, trunk, hip, pelvis and spine) was assessed by whole body dual-energy X-ray absorptiometry (DXA) at baseline and one year after dialysis start. Framingham cardiovascular disease (CVD) risk score, body composition, nutritional status, handgrip strength, various biochemical biomarkers (white blood cell, hemoglobin, albumin, creatinine, calcium, phosphate, intact parathyroid hormone, triglyceride, cholesterol, HDL cholesterol and high-sensitivity C-reactive protein) were recorded. We used multivariate linear regression analysis for BMD change analysis. We followed patients from 12 months after initiating of dialysis until renal transplantation, death or end of 60 months follow-up. During follow-up, 59 patients (24%) died due to CVD (n=33) or other causes (n=26) and 95 patients (39%) underwent renal transplantation. Fine and Gray competing risk analysis was used to ascertain associations of BMD changes with all-cause and CVD-related mortality. Results From baseline to one year after initiation of dialysis, there was a significant decrease of BMDtotal and BMDleg, trunk, rib, pelvis and spine in hemodialysis (HD) patients, whereas no difference was seen in peritoneal dialysis (PD) patients. In multivariate linear regression analysis adjusting for several confounders, HD therapy - compared to PD therapy - was significantly associated with negative changes in BMDtotal (β=-0.15), BMDhead (β=-0.14), BMDleg (β=-0.18) and BMDtrunk (β=-0.16). The direction and extent of changes in BMD, i.e. increase of BMD, associated with statistically significant lower all-cause mortality risk for BMDtotal (sHR, 0.91), BMDhead (sHR 0.91) and BMDleg (sHR 0.92), while for CVD-mortality a significant association with BMD changes was found only for changes in BMDhead (sHR 0.92). Conclusion In patients starting on dialysis, PD therapy appeared to have a beneficial effect on BMD changes as compared to HD during the first year of dialysis therapy. This difference may have implications for clinical outcomes as the degree of bone loss was associated with subsequent mortality. Changes towards increased BMDtotal, BMDhead and BMDleg associated with lower all-cause mortality. For head region – which is known as a cortical bone rich site – positive BMD change associated also with lower CVD mortality suggesting that increase or maintenance of BMD of cortical bone rich sites may have stronger association with clinical outcome in ESRD than BMD of trabecular bone.

scholarly journals Study of Outcome of Ischemic Stroke Patient With Atrial Fibrillation

2018 ◽  
Vol 28 (2) ◽  
pp. 1-6
Author(s):  
Achinta Kumar Mallick ◽  
Md Kafil Uddin ◽  
Md Ahmed Ali ◽  
Pijus Kumar Kundu ◽  
Sheikh Mohammad Emdadul Haque ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Linear Regression Analysis ◽  
Clinical Deterioration ◽  
Stroke Recurrence ◽  
Stroke Severity ◽  
Multivariate Linear Regression Analysis ◽  
Stroke Patients

Atrial fibrillation (AF) is a common arrhythmia and a major risk factor for ischemic stroke, especially in the elderly. Patients with nonvalvular AF have a 5-fold excess risk of stroke. However, population-based data are scarce in patients who have experienced a first-ever ischemic stroke in the presence of AF regarding long-term risk of stroke recurrence and case-fatality rate. Aim of the study is to find out the outcome of ischemic stroke patients with Atrial Fibrillation. It was a descriptive type cross sectional study where 125 diagnosed cases of ischemic stroke were included. Presence of atrial fibrillation was detected by electrocardiogram. They were divided into two groups – those with atrial fibrillation and those without. Comparison was done between the two group in term of recurrence, mortality and clinical improvement. Atrial fibrillation was present in 22 (17.6%) of 125 patients with ischemic stroke. Those with AF were more frequently male, aged 45 years and older. The presence of AF was associated with high 3 months (Χ2 =4.562, df = 1, p<0.05) and 6 months mortality (Χ2 =7.868, df = 1, p<0.05), with a higher stroke recurrence rate within the first 6 months follow-up (22.7% versus 7.8% (<0.05)). At 3 months follow up clinical deterioration was noted in 9.1% patient with atrial fibrillation compared to 2.9% patients who had no arrhythmia(p<0.01) and at 6 months follow up clinical deterioration was noted in 18.2% patient with atrial fibrillation compared to 4.9% patients who had no arrhythmia(p<0.01). Ischemic stroke patients with atrial fibrillation had significant mortality within the study period compared to those without atrial fibrillation. Significant deterioration in clinical outcome was noted in atrial fibrillation group after six months. Recurrence was more in ischemic stroke patients with atrial fibrillation. Multivariate linear regression analysis shows atrial fibrillation as well as CKD, Diabetes mellitus and smoking as independent risk factor for recurrence. In conclusion, patients who had an ischemic stroke with accompanying atrial fibrillation had higher mortality, grave stroke severity, more recurrences and poorer functional status than those without atrial fibrillation.TAJ 2015; 28(2): 1-6

High-Grade Cervical Intraepithelial Neoplasia (CIN) in Pregnancy: Clinicotherapeutic Management

1998 ◽  
Vol 84 (5) ◽  
pp. 567-570 ◽  
Author(s):  
Carlo Penna ◽  
Maria Grazia Fallani ◽  
Maria Maggiorelli ◽  
Elisa Zipoli ◽  
Alessandra Cardelli ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Cervical Intraepithelial Neoplasia ◽  
Young Women ◽  
Intraepithelial Neoplasia ◽  
Histologic Examination ◽  
First Year ◽  
High Grade ◽  
In Pregnancy

An increasing incidence of cervical intraepithelial neoplasia (CIN) among young women has been noticed in recent years. For this reason pregnancy might represent a peculiar opportunity to undergo cytocolposcopic examination for those women who do not take part in a screening program for cervical carcinoma. Diagnosis of CIN during pregnancy poses the question of the management of this disease and particularly of whether it is better to treat the lesion or not during pregnancy. To contribute to the solution of this issue we initiated a study on the management of high-grade CIN in pregnancy. Material and methods Five hundred and seventy-one pregnant women underwent cytologic, colposcopic and, when necessary, histologic examination. Those in whom a CIN was discovered in the first four months of gestation underwent laser conization. When the diagnosis of CIN was made after the sixteenth week of gestation, cytocolposcopic monitoring was performed every eighth week during pregnancy and two months after childbirth. Laser conization was performed under colposcopic guidance in the outpatient setting in all cases. All treated patients were submitted to cytologic, colposcopic and, if necessary, histologic examination every third month in the first year after treatment, every sixth month in the second year and yearly from the third year onwards. Results In 14 (2.4%) of the 571 examined women a CIN III was discovered, 6 of which associated with a human papilloma virus (HPV) infection. Of these, 8 patients, whose diagnosis was made within the sixteenth week of pregnancy, underwent laser conization. In one case a minor hemorrhage occurred during treatment. Two patients reported minor bleeding up to ten days after treatment. No major hemorrhages or cervical stenosis were observed. Histologic examination of the cones confirmed the preoperative diagnosis based on cervical biopsies and the lesion was entirely removed by conization in all cases. Seven of the 8 patients who underwent laser conization during pregnancy had a spontaneous delivery at term. The remaining patient, who had had a previous cesarean section, was again delivered by cesarean section. All treated patients were cured after the first-year follow-up visit. In 6 patients CIN was diagnosed after the sixteenth week of pregnancy. These women underwent cytocolposcopic examination every eighth week during pregnancy and two months after delivery, when the cervical changes associated with gestation had disappeared. Four of these patients showed persistence of CIN at postpartum follow-up and therefore underwent laser conization. In two patients spontaneous regression of the lesion was observed. In no case did progression to invasive carcinoma occur. Conclusions Given the increasing incidence of CIN in young women, the beginning of pregnancy may represent a peculiar opportunity for all pregnant women who do not take part in cervical screening programs to undergo a cytocolposcopic examination. In case of a diagnosis of high-grade CIN within the first 16 weeks of pregnancy, a conservative excisional treatment, which does not expose the pregnancy to any risk, should be carried out in order to confirm the intraepithelial localization of the lesion.

scholarly journals P0845INCREASING TOTAL RENAL VOLUME AFTER NEPHRECTOMY FOR RENAL CELL CARCINOMA IS ASSOCIATED WITH RENAL FUNCTION EVOLUTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
SAUL PAMPA-SAICO ◽  
M Soledad Pizarro-Sánchez ◽  
Simona Alexandru ◽  
Laura García Puente-Suárez ◽  
María López-Picasso ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Renal Volume

Abstract Background and Aims Renal cell carcinoma is the most common form of kidney cancer. Reduction of renal mass after radical nephrectomy (RN) in these patients, results in compensatory hypertrophy of the contralateral kidney. The capacity of compensation will determine the renal function (RF) evolution. Measuring of total renal volume (TRV) of the remaining kidney pre and post RN can help assess the RF evolution. Aims To determine the correlation between TRV pre and post nephrectomy (a year of follow-up) with RF and the factors that modify. Method A retrospective cohort study was carried out in our institution, in 62 patients who had underwent RN from 2014 to 2018, due to renal cell carcinoma (confirmed by histopathology). The demographic data included age, gender, body mass index (BMI), associated comorbidities, smoking habits were collected. Serum creatinine, estimated glomerular filtration rate (eGFR) and proteinuria were collected in the preoperative period and in the follow-up. The TRV was calculated pre and post (a year of follow-up) RN, using ellipsoid formula equation (computed tomography scan or magnetic resonance imaging). Renal function evolution was assessed by eGFR using the modification of diet in Renal Disease formula. Multivariate linear regression analysis was used to determine the predictor of TRV at 1 year of follow-up. Results The median age at the time of RN was 71 years old (range, 43-86 years). Most of them were men, 69% (43/19). The estimated glomerular filtration rate (FGe) pre and post nephrectomy was 74 (41-102) and 52.1 ml/min/ m2 (22-89) respectively (P=0.013). The TRV pre and post-nephrectomy was 165.3 (102.3-259.7) and 188.3 ml (115.3-271.2) respectively (P=0.001). On multivariate linear regression analysis, controlling for age and sex; the pre-nephrectomy FGe (β = 0.42; P = 0.023) and the pre TRV (β = 1.23; P &lt;0.0001) were positively correlated with the post-nephrectomy TRV, while the FGe at year of follow-up was correlated negatively (β = -1.11; P = 0.024) Conclusion The post nephrectomy TRV was positively correlated with TRV and FGe pre nephrectomy. While with the FGe at one year post nephrectomy was negatively correlated. The increasing TRV pre and post nephrectomy can help to predict renal function at a year of follow-up in this group of patients.

scholarly journals A Correlational Study Between Attachment Behaviors and Spiritual Health with Stress in Pregnant Women Referred to Healthcare Centers in Qazvin, Iran, in 2015

2020 ◽  
Vol 14 (4) ◽  
Author(s):  
Elnaz Haji Rafiei ◽  
Shahnaz Torkzahrani ◽  
Sepideh Hajian ◽  
Hamid Alavi Majd
Keyword(s):  
Pregnant Women ◽  
Prenatal Stress ◽  
Linear Regression Analysis ◽  
Sampling Technique ◽  
Well Being ◽  
Spiritual Health ◽  
Multivariate Linear Regression Analysis ◽  
Cross Sectional ◽  
Maternal Fetal Attachment ◽  
Fetal Attachment

Background: Prenatal stress causes negative health outcomes for the mother and fetus. Hence, investigating coping strategies is essential to reduce such negative effects. Objectives:: The current study aimed to investigate the correlation between attachment behaviors and spiritual health with stress during pregnancy. Methods: In this cross-sectional study, 200 pregnant women referred to the health centers affiliated to Qazvin University of Medical Sciences in 2015 are studied. Participants were selected using the multi-stage sampling technique. Data were collected using Paloutzian & Ellison's Spiritual Well-Being Scale, Cranley's Maternal-Fetal Attachment Scale, the Pregnancy Stress Scale, and a researcher-made questionnaire consisting of demographic and midwifery information. Data were analyzed by SPSS version 20 using Pearson’s correlation coefficient and the multivariate linear regression analysis. Results: The mean scores for spirituality, attachment behaviors, and prenatal stress were 104.15 ± 10.59, 95.91 ± 8.9, and 88.92 ± 36.93, respectively. A positive weak correlation was spotted between attachment and stress (P = 0.02, r = 0.15), and spiritual health was found to have a negative, weak but significant association with the financial status (P < 0.001, r = -0. 22) and personal-family (P = 0. 03, r = -0.14) subscales of stress. No significant correlation was observed between spiritual health and the total score of stress (P > 0.05). Conclusion: This study demonstrated that maternal-fetal attachment was correlated with prenatal stress while spiritual health was not correlated with prenatal stress; however, spiritual health could predict some subscales of stress.

scholarly journals Influence of maternal use of tenofovir disoproxil fumarate or zidovudine in Vietnamese pregnant women with HIV on infant growth, renal function, and bone health

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250828
Author(s):  
Ei Kinai ◽  
Hoai Dung Thi Nguyen ◽  
Ha Quan Do ◽  
Shoko Matsumoto ◽  
Moeko Nagai ◽  
...  
Keyword(s):  
Renal Function ◽  
Pregnant Women ◽  
Renal Dysfunction ◽  
Bone Health ◽  
Tenofovir Disoproxil Fumarate ◽  
Serum Alkaline Phosphatase ◽  
Linear Regression Analysis ◽  
Infant Growth ◽  
Multivariate Linear Regression Analysis ◽  
Growth Impairment

Tenofovir disoproxil fumarate (TDF) is still widely prescribed for human immunodeficiency virus (HIV)-infected pregnant women, despite its renal and bone toxicity. Although TDF-exposed infants often show transient growth impairment, it is not clear whether maternal TDF causes infantile rickets via maternal/fetal renal dysfunction in Asian populations. This prospective observational study was conducted in Vietnam and involved pregnant HIV-infected women treated with TDF-based regimen (TDF group) or zidovudine-based regimen (AZT-group). At birth, 3, 12, and 18 months of age, and included body length, weight, head circumference, serum alkaline phosphatase (ALP), creatinine, calcium, phosphorus, urine-β2-microglobulin (U-BMG), percentage of tubular reabsorption of phosphate (%TRP), and radiographic wrist score for rickets. Age-adjusted multivariate linear regression analysis evaluated the association of TDF/AZT use during pregnancy with fetal renal function and bone health. The study included 63 mother-infant pairs (TDF group = 53, AZT group = 10). In the mothers, detectable U-BMG (>252 μg/L) was observed more frequently in the TDF- than AZT group (89 vs 50%, p<0.001), but other renal/bone parameters were similar. In infants, maternal TDF use was not associated with growth impairment, renal dysfunction, or abnormal bone findings, but with a slightly higher ALP levels (p = 0.019). However, shorter length was associated with maternal AZT (p = 0.021), and worse radiographic scores were associated with LPV/r (p = 0.024). In Vietnamese population, TDF usage during pregnancy was not associated with infant transient rickets, growth impairment, or renal dysfunction, despite mild maternal tubular impairment. Maternal AZT and LPV/r influenced infant growth and bone health, though further studies are needed to confirm this finding.

scholarly journals Reducing Stress in Youth: A Pilot-Study on the Effects of a University-Based Intervention Program for University Students in Pune, India

2016 ◽  
Vol 6 (2) ◽  
pp. 53 ◽  
Author(s):  
Emma Emily De Wit ◽  
Adithy ◽  
Joske G. F. Bunders-Aelen ◽  
Barbara J. Regeer
Keyword(s):  
Pilot Study ◽  
Perceived Stress ◽  
Mental Health Problems ◽  
Well Being ◽  
Mental Wellbeing ◽  
Health Concern ◽  
P Value ◽  
Base Line ◽  
The Impact

<p>Mental health problems among youth have become important public health concern for many low &amp; middle- income countries. As part of a research program to improve mental wellbeing in Pune, India, a university-based intervention was developed for students of two educational institutes. In one month, 33 students (age 18-22) participated in a series of 2-hour sessions in which they were stimulated to learn better coping skills to deal with stress and anxiety. The interactive sessions were facilitated by a psychologist and volunteers of a suicide prevention NGO. Rational Emotive Behaviour Therapy (REBT) approaches were used to help students identify stressors and find alternative thought patterns towards the stressor. Playful exercises, such as theatre, dance and poetry, were used to develop self-esteem, self-expression and a better sense of control in students. Throughout the program, relaxation methods, such as Emotional Freedom Technique (EFT), were practiced to help reduce stress in students. To study the impact of the intervention, data were collected, before- and after the intervention and in an eight month follow-up with the Perceived Stress Scale (PSS), in combination with open questionnaires and field notes. Preliminary results show a significant decrease in average stress scores in students after the program in comparison to before the intervention (p-value is 0.044 &lt; 0.05). Students reflect upon the program as helpful and specifically emphasize the role of poetry, dance &amp; EFT as main contributors. In follow-up tests perceived stress scores remained lower than at base-line, although not significant. Booster sessions are suggested to sustain the benefits. Overall, the results of this pilot study show that low threshold, university-based interventions, could be useful in stimulating psychosocial well-being in youth.</p><p> </p>

Does Olfaction Improve After Endoscopic Sinus Surgery?

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P74-P74
Author(s):  
Jamie R. Litvack ◽  
Jess Collin Mace ◽  
Timothy L Smith
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Linear Regression Analysis ◽  
Olfactory Dysfunction ◽  
Sinus Surgery ◽  
Multivariate Linear Regression Analysis ◽  
Co Morbidity ◽  
Long Term Follow Up ◽  
The Impact

Objective No large, prospective, multi-institutional cohort studies have objectively examined the impact of surgery on olfaction with long-term follow-up. The aim of this study was to objectively examine the impact of endoscopic sinus surgery (ESS) on olfactory dysfunction (hyposmia) would benefit from ESS, whereas patients with severe olfactory dysfunction (anosmia) would not. Methods In this prospective, multi-institutional cohort study, 111 patients presenting for ESS for treatment of CRS were examined pre-operatively and at 6 and 12 months postoperatively. Demographic, co-morbidity and Smell Identification Test (SIT) data were collected at each time point. Univariate and multivariate analyses were performed. Results The prevalence of gender-adjusted olfactory dysfunction prior to surgery was 67.5%: 50.4% of patients were hyposmic and 17.1% were anosmic. Surprisingly, hyposmic patients did not significantly improve after surgery (baseline, 6 month, 12 month mean SIT scores: 28.8, 30.0, 29.5). In contrast, patients with anosmia significantly improved after ESS (baseline, 6 month, 12 month mean SIT scores: 9.3, 21.3, 21.7; p=0.001); furthermore, improvement was sustained at 12-month follow-up (p=0.001). Multivariate linear regression analysis showed that baseline olfactory category and nasal polyposis were significantly associated with improvement in postoperative olfactory function (p=0.035, p=0.002), whereas age, gender, and disease-severity as measured by CT and endoscopy scores were not. Conclusions Contrary to our hypothesis, patients with severe olfactory dysfunction significantly improved after ESS and sustained improvement over time, whereas patients with mild olfactory dysfunction did not.

scholarly journals Outcomes of 3-D corrective osteotomies for paediatric malunited both-bone forearm fractures

2021 ◽  
pp. 175319342110295
Author(s):  
Kasper C. Roth ◽  
Eline M. van Es ◽  
Gerald A. Kraan ◽  
Jan A. N. Verhaar ◽  
Filip Stockmans ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Corrective Osteotomy ◽  
Primary Outcome Measure ◽  
Patient Specific ◽  
Multivariate Linear Regression Analysis ◽  
Forearm Fractures ◽  
Level Of Evidence ◽  
Surgical Guides ◽  
Closed Treatment

Closed treatment of paediatric diaphyseal forearm fractures carries the risk of re-displacement, which can lead to symptomatic malunions. This is because growth will not correct angulation deformity as it does in metaphyseal fractures. The purpose of this prospective cohort study was to evaluate the outcomes after 3-D-planned corrective osteotomy with patient-specific surgical guides for paediatric malunited forearm fractures causing impaired pro-supination. Our primary outcome measure was the gain in pro-supination at 12 months follow-up. Fifteen patients with a mean age at trauma of 9.6 years and time until osteotomy of 5.9 years were included. Preoperatively, patients displayed a mean pro-supination of 67° corresponding to 44% of the contralateral forearm. At final follow-up, this improved to 128°, achieving 85% of the contralateral side. Multivariate linear regression analysis revealed that predictors of greater functional gain after 3-D corrective osteotomy are severe preoperative impairment in pro-supination, shorter interval until 3-D corrective osteotomy and greater angulation of the radius. Level of evidence: III

P2605Liver stiffness assessed by fibrosis-4 index; noninvasive marker using serum biomarkers is associated with right ventricular function and cardiovascular prognosis in HFpEF

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Nakashima ◽  
S Sakuragi
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Linear Regression Analysis ◽  
Liver Stiffness ◽  
Right Atrial ◽  
Multivariate Linear Regression Analysis ◽  
Cardiac Events ◽  
Kaplan Meier ◽  
Rv Function

Abstract Background Liver stiffness is reported to be associated with right atrial pressure and worse prognosis of heart failure. Fibrosis-4 (FIB4) index (age (years) × aspartate aminotransferase (IU/L)/platelet count (109/L) × square root of alanine aminotransferase (IU/L)) is known as a useful and simple marker for evaluating liver stiffness. However, the association between FIB4 index and prognosis in heart failure with preserved ejection fraction (HFpEF) was not elucidated. Purpose This study aimed to clarity the association between FIB4 index and right ventricular (RV) function and major adverse cardiac events (MACE) of HFpEF. Method From February 2012 to December 2015, 132 subjects diagnosed as HFpEF after hospitalization of acute decompensation were enrolled (79 years, 59 male). Subjects performed thoracic surgery or percutaneous coronary intervention within half a year and died before discharge were excluded. All subjects were measured FIB4 index and tricuspid annular plane systolic excursion (TAPSE) to assess RV function before discharge. In addition, patients were classified into two groups: high-(≥3.01, n=52) and low-FIB4 index groups (<3.01, n=80). MACE incidence during the follow-up period were compared between these groups. Results Patient with high-FIB4 index were older and higher level of blood pressure. There was no difference in prevalence rates of history of liver disease. In multivariate Linear regression analysis, FIB4 index was significantly association with TAPSE independently confounding factors. Kaplan-Meier analysis showed that patients with high-FIB4 index experienced more CV events during the 1734 days of follow-up (42.3% vs 26.2%, p=0.028) (figure). Kaplan-Meier curve freedom from MACE Conclusions FIB4 index is associated with RV dysfunction and a high risk of future CV event of HFpEF.

Sign in / Sign up

Export Citation Format

Share Document