scholarly journals Risk for stroke and chronic kidney disease in patients with sleep apnea syndrome and heart failure with different ejection fractions

Pneumologia ◽  
2019 ◽  
Vol 68 (1) ◽  
pp. 15-20
Author(s):  
Carmen Ardelean ◽  
Daniel Lighezan ◽  
Raluca Morar ◽  
Sorin Pescariu ◽  
Stefan Mihăicuță
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Sleep Apnea Syndrome ◽  
Central Apnea ◽  
Obstructive Apnea ◽  
Tricuspid Insufficiency ◽  
Increased Risk ◽  
Apnea Syndrome ◽  
Group 2 ◽  
Group 1

Abstract Background Patients with sleep apnea syndrome (SAS) and heart failure (HF) have concomitant different comorbidities and increased risk of morbidity. Aim The aim of this study was to analyze differences between patients with SAS and heart failure with preserved ejection fraction (HFpEF; ejection fraction [EF]≥50%) – group 1 and those with SAS and heart failure with reduced ejection fraction (HFrEF; EF<50%) – group 2. Methods We evaluated 51 patients with SAS and HF in the sleep laboratory of Timisoara Victor Babes Hospital. We collected general data, sleep questionnaires, anthropometric measurements (neck circumference [NC], abdominal circumference [AC]), somnography for apnea–hypopnea index (AHI), oxygen desaturation index (ODI), echocardiographic data, comorbidities, and laboratory test. Results The study included 51 patients who were divided into two groups depending on EF, with the following characteristics: Group 1 (HFpEF): 26 patients, 19 males, seven females, age 61.54±9.1 years, body mass index (BMI) 37±6.4 kg/m2, NC 45.4±3.6 cm, AC 126.6±12.9 cm, AHI 48.3±22.6 events/hour, central apnea 5.6±11.4 events/hour, obstructive apnea 25.7±18.7 events/hour, ODI 41.2±21.2/hour and lowest SpO2 –72.1±14%. Group 2 (HFrEF): 25 patients, 18 males, seven females, age 63.6±8.8 years, BMI 37.9±7.5 kg/m2, NC 46±4.4 cm, AC 127.2±13.9 cm, AHI 46.4±21.7 events/hour, central apnea 4.6±8.3 events/hour, obstructive apnea 25.9±18.5 events/hour, ODI 44.8±27.1/hour and lowest SpO2 –70.6±12.1%. Differences between groups regarding anthropometric and somnographic measurements and lipidic profile were not statistically significant. Significant differences were observed regarding stroke (23% vs. 4%, p=0.04) in the group with HFpEF and regarding creatinine measurements (1.1±0.2 vs. 1.4±0.7, p=0.049), aortic insufficiency (11.5% vs. 36%, p=0.04) and tricuspid insufficiency (6.1% vs. 80%, p=0.01) in the group with HFrEF. Conclusions Patients with SAS and HFpEF have a higher risk of stroke. Patients with SAS and HFrEF have a significantly increased risk of developing a life-long chronic kidney disease and aortic and tricuspid insufficiency. These results may suggest pathogenic links between SAS and the mentioned comorbidities, and this may explain the higher mortality when this association is present.

scholarly journals Prognostic value of soluble ST2 biomarker in heart failure patients with obstructive sleep apnea syndrome

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Kopeva ◽  
EV Grakova ◽  
AV Yakovlev ◽  
SN Shilov ◽  
NF Yakovleva ◽  
...  
Keyword(s):  
Heart Failure ◽  
Odds Ratio ◽  
Sleep Apnea Syndrome ◽  
Myocardial Mass ◽  
Heart Failure Patients ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: None. Objective. To analyze the relationships between soluble ST2 (sST2) levels, apnea/hypopnea index (AHI) and echocardiographic parameters in heart failure patients with preserved ejection fraction (HFpEF) and to evaluate prognostic values of sST2 in the development of adverse cardiac events (ASE) during the 12-month follow-up period. Methods. A total of 86 men, median age of 62.0 (41.0; 78.0) years with obstructive sleep apnea syndrome (OSAS) and HF of NYHA class I-III with baseline LVEF of 60% [52; 65]% were enrolled in the study. The severity of obstructive breathing disorders during sleep was assessed by AHI. Serum levels of NT-proBNP and sST2 were measured using ELISA at baseline. Two-dimensional transthoracic echocardiography with assessment of right ventricular (RV) function and 6-minute walk test (6MWT) were performed at baseline. Results. The values of AHI significantly correlated with body mass index (r = 0.362), left atrial volume (r = 0.570), fractional change in the area of the RV (r=-0.527), RV myocardial function index (r=-0.377), NT-proBNP (r = 0.611), 6MWT (r=-0.511), RV anterior wall thickness (r = 0,472), while the levels of sST2 significantly correlated with LV remodeling parameters: LVEF (r =-0.301), end-systolic volume (r =0.453), end-diastolic volume (r =0.396), end-systolic dimension (r = 0.373), end-diastolic dimension (r =0.288). Based on ROC-analysis, sST2 ≥29.67 ng/mL (sensitivity 63.6%, specificity 73.6%, AUC = 0.645; p &lt; 0.0001) were identified as a cut-off values predicting the development of ACE. At 12 months of follow-up period all patients were divided into 2 groups according to cut-off values of sST2: group 1 (n = 29) comprised patients with sST2 ≥29.67 ng/mL, group 2 (n = 42) comprised patients with sST2 &lt;29.67 ng/mL. The median baseline values of sST2 were 41.39 [33.31; 50.99] ng/mL in group 1, and 22.18 [20.64; 25.5] ng/mL in group 2. The concentrations of NT-proBNP did not differ between the groups. During the 12-month follow-up period in group 1 the rate of ACE was 29.7% cases, and 5.2% in group 2, respectively. According to Kaplan-Meier analysis, a higher sST2 levels was associated with a higher frequency of ACE during 12 months of follow-up (р&lt;0.0001). Univariable and multivariable Cox regression analyses showed sST2 concentrations were significantly associated with ACE (odds ratio 2.25, 95%CI: 2.06 to 3.29, p &lt; 0.001), when adding AHI and LV myocardial mass index improved reclassification of risk stratification (odds ratio 3,28, 95%CI: 3,09 to 4,49, p &lt; 0.001, AUC of 0.945, percent of cases correctly classified of 90.14 %). However, NT-proBNP addition had a limited effect on risk stratification. Conclusion. Our data suggest that sST2 may be used as a diagnostic biomarker for prediction of ACE in patients with HFpEF and OSAS during the 12-month follow-up period. The combined evaluation of sST2, AHI and LV myocardial mass index values demonstrated higher diagnostic sensitivity and specificity for prediction of ACE.

scholarly journals Different Pathophysiology and Outcomes of Heart Failure With Preserved Ejection Fraction Stratified by K-Means Clustering

2020 ◽  
Vol 7 ◽  
Author(s):  
Daisuke Harada ◽  
Hidetsugu Asanoi ◽  
Takahisa Noto ◽  
Junya Takagawa
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Preserved Ejection Fraction ◽  
Stratified Medicine ◽  
Cardiac Events ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Stratified medicine may enable the development of effective treatments for particular groups of patients with heart failure with preserved ejection fraction (HFpEF); however, the heterogeneity of this syndrome makes it difficult to group patients together by common disease features. The aim of the present study was to find new subgroups of HFpEF using machine learning.Methods: K-means clustering was used to stratify patients with HFpEF. We retrospectively enrolled 350 outpatients with HFpEF. Their clinical characteristics, blood sample test results and hemodynamic parameters assessed by echocardiography, electrocardiography and jugular venous pulse, and clinical outcomes were applied to k-means clustering. The optimal k was detected using Hartigan's rule.Results: HFpEF was stratified into four groups. The characteristic feature in group 1 was left ventricular relaxation abnormality. Compared with group 1, patients in groups 2, 3, and 4 had a high mean mitral E/e′ ratio. The estimated glomerular filtration rate was lower in group 2 than in group 3 (median 51 ml/min/1.73 m2 vs. 63 ml/min/1.73 m2p &lt; 0.05). The prevalence of less-distensible right ventricle and atrial fibrillation was higher, and the deceleration time of mitral inflow was shorter in group 3 than in group 2 (93 vs. 22% p &lt; 0.05, 95 vs. 1% p &lt; 0.05, and median 167 vs. 223 ms p &lt; 0.05, respectively). Group 4 was characterized by older age (median 85 years) and had a high systolic pulmonary arterial pressure (median 37 mmHg), less-distensible right ventricle (89%) and renal dysfunction (median 54 ml/min/1.73 m2). Compared with group 1, group 4 exhibited the highest risk of the cardiac events (hazard ratio [HR]: 19; 95% confidence interval [CI] 8.9–41); group 2 and 3 demonstrated similar rates of cardiac events (group 2 HR: 5.1; 95% CI 2.2–12; group 3 HR: 3.7; 95%CI, 1.3–10). The event-free rates were the lowest in group 4 (p for trend &lt; 0.001).Conclusions: K-means clustering divided HFpEF into 4 groups. Older patients with HFpEF may suffer from complication of RV afterload mismatch and renal dysfunction. Our study may be useful for stratified medicine for HFpEF.

1409Use of phenomapping to determine response of treatment by sacubitril/valsartan in patients with heart failure with reduced ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Godet ◽  
O Raitiere ◽  
H Chopra ◽  
P Guignant ◽  
C Fauvel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Heat Map ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Treatment by sacubitril/valsartan decreases mortality, improves KCCQ score and ejection fraction in patients with heart failure with reduced ejection fraction (HF REF), but there is currently no data to predict response to treatment. Purpose The purpose of our work was to assess whether unbiased clustering analysis, using dense phenotypic data, could identify phenotypically distinct HF-REF subtypes with good or no response after 6 months of sacubitril/valsartan administration. Methods A total of 78 patients in NYHA functional class 2–3 and treated by ACE inhibitor or AAR2, were prospectively assigned to equimolar sacubitril/valsartan replacement. We collected demographic, clinical, biological and imaging continuous variables. Phenotypic domains were imputed with 5 eigenvectors for missing value, then filtered if the Pearson correlation coefficient was >0.6 and standardized to mean±SD of 0±1. Thereafter, we used agglomerative hierarchical clustering for grouping phenotypic variables and patients, then generate a heat map (figure 1). Subsequently, participants were categorized using Penalized Model-Based Clustering. P<0,05 was considered significant. Results Mean age was 60.4±13.4 yo and 79.0% patients were males. Mean ejection fraction was 29.3±7.0%. Overall, 16 phenotypic domains were isolated (figure 1) and 3 phenogroups were identified (Table 1). Phenogroup 1 was remarkable by isolated left ventricular involvement (LVTDD 64.3±5.9mm vs 73.9±8.7 in group 2 and 63.8±5.7 in group3, p<0.001) with moderate diastolic dysfunction (DD), no mitral regurgitation (MR) and no pulmonary hypertension (PH). Phenogroups 2 and 3 corresponded to patients with severe PH (TRMV: 2.93±0.47m/s in group 2 and 3.15±0.61m/s in groupe 3 vs 2.16±0.32m/s in group 1), related to severe DD (phenogroup 2) or MR (phenogroup 3). In both phenogroups, the left atrium was significantly enlarged and the right ventricle was remodeled, compared with phenogroup 1. Despite more severe remodeling and more compromised hemodynamic in phenogroups 2 and 3, the echocardiographic response to sacubitril/valsartan was comparable in all groups with similar improvement of EF and reduction of cardiac chambers dimensions (response of treatment, defined by improvement of FE +15% and/or decreased of indexed left ventricule diastolic volume −15% = group 2: 22 (76%); group 3: 18 (60%); group 1: 9 (50%); p=0.17; OR group 2 vs 1: OR=3.14; IC95% [0.9–11.03]; p=0.074; OR group 3 vs 1: OR=1.5; IC95% [0.46–4.87]; p=0.5)). The clinical response was even better in phenogroups 2 and 3 (Group 2: 19 (66%); group 3: 21 (78%) vs group 1: 9 (50%); p=0.05). Heat map Conclusion HF-REF patients with severe diastolic dysfunction, significant mitral regurgitation and elevated pulmonary hypertension by echocardiographic had similar reverse remodeling but better clinical improvement than patients with isolated left ventricular systolic dysfunction.

Abstract 16477: Sacubitril/valsartan as a Treatment for Resistant Hypertension in Patients With Heart Failure and Preserved Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Pardeep S Jhund ◽  
Alice M 1 ◽  
Marc A Pfeffer ◽  
Faiez ZANNAD ◽  
Martin P Lefkowitz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Resistant Hypertension ◽  
Preserved Ejection Fraction ◽  
Mineralocorticoid Receptor Antagonist ◽  
Drug Classes ◽  
Neprilysin Inhibitor ◽  
Group 2 ◽  
Design And Methods ◽  
Group 1

Objective: Heart failure with preserved ejection fraction (HFpEF) is typically a hypertensive phenotype and many HFpEF patients have difficult to control hypertension. We examined the effect of neprilysin inhibition on resistant hypertension in HFpEF patients in the PARAGON-HF trial. Patients entered a 1 to 4-week valsartan run-in (target dose 80mg bd), followed by sacubitril/valsartan run-in, before randomization to valsartan or sacubitril/valsartan (target doses 160mg bd or 200mg bd respectively). Design and methods: Patients were examined according to different definitions of resistant hypertension using systolic blood pressure (SBP) at the end of valsartan run-in. Group 1: SBP≥140mmHg (≥135mmHg if diabetes) despite treatment with a calcium channel blocker (CCB), diuretic and valsartan, Group 2: SBP≥130mmHg despite treatment with a CCB, diuretic and valsartan, or SBP<130mmHg despite treatment with a CCB, diuretic, mineralocorticoid receptor antagonist (MRA) and valsartan, and Group 3: SBP≥140mmHg (≥135mmHg if diabetes) despite treatment with a CCB, diuretic, MRA and valsartan (≥4 classes of SBP-reducing therapy, including MRA). We examined reduction in SBP from end of valsartan run-in to weeks 4 and 16 after randomization and the proportion of patients with controlled SBP at week 16 on sacubitril/valsartan vs valsartan. Results: Of 4796 patients randomized, criteria for resistant hypertension were fulfilled in 726 (15%) using the Group 1 definition, 1146 (24%) using the Group 2 definition and 132 (3%) in the third group. The combination of neprilysin inhibitor, angiotensin receptor blocker, CCB and diuretic (+/-MRA) reduced SBP and significantly increased the proportion of patients with controlled SBP (Table). Conclusion: Sacubitril/valsartan may be useful in treating resistant hypertension in patients with HFpEF, even in those who continue to have an elevated SBP despite treatment with at least 4 antihypertensive drug classes, including an MRA.

scholarly journals The significance of rate pressure product in heart failure patients

2015 ◽  
Vol 1 (1) ◽  
pp. 43 ◽  
Author(s):  
Kamilu Karaye ◽  
AA Akintunde
Keyword(s):  
Heart Failure ◽  
Oxygen Consumption ◽  
Myocardial Oxygen Consumption ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Rate Pressure Product ◽  
Black African ◽  
Increased Risk ◽  
Group 2 ◽  
Group 1

<p><span>Introduction: </span>The rate pressure product (RPP) is a strong determinant of myocardial oxygen consumption, and relates strongly to important indices for morbidity and cardiovascular mortality. Its significance in Black-African subjects with heart failure (HF) has however not been well described. This study therefore aimed to assess the significance of RPP among admitted HF patients in 2 Nigerian centres.</p><p><span>Methods: </span>Admitted HF patients in the 2 centres were serially recruited after satisfying all inclusion criteria. RPP was calculated by multiplying heart rate by systolic blood pressure at admission. Subjects were classified into 2 groups based on RPP &lt;10,000 (log10 &lt;4.0) (group 1) or above (group 2), which is a cut-off value above which there is increased risk of myocardial ischemia.</p><p><span>Results: </span>100 subjects were recruited from the 2 centres with a mean age of 47.3+/-19.5 years, and 53% were females. 35% of the subjects were in group 1 while 65% were in group 2. N-Terminal B-type Natriuretic Peptide (NTBNP), serially measured in only 37 subjects (12 in group 1; 25 in group 2), was significantly higher in group 1 as compared with group 2 (p=0.016). Group 1 also had lower interventricular septal thickness(IVST) (p=0.007) as compared with group 2 subjects. RPP correlated strongly with IVST (r=+0.510, p&lt;0.001), left ventricular posterior wall thickness (LVPWT) (r=+0.399, p&lt;0.001) and LV end-diastolic dimension (LVEDD) (r=-0.202, p=0.045). Log10 &gt;4.0 was strongly associated with IVST (95%confidence interval (CI): 1.061-1.528, p=0.009) and NT-BNP (CI:0.999-1.000, p=0.026). There was however no significant relationship (p&gt;0.05) between RPP and in-hospital mortality, severity of dyspnoea, gender, age, body weight, LV ejection fraction or presence of atrial fibrillation/flutter.</p><p><span>Conclusion: </span>This study confirms the close relationship that exists between a determinant of myocardial oxygen consumption (RPP), and indices for LV wall tension (IVST, LVEDD and NT-BNP), in Black-Africans with HF.</p>

scholarly journals Beta Blockers Up-Titration in Patients with Heart Failure Reduced Ejection Fraction and Cardiac Resynchronization Therapy, a Single Center Study

2019 ◽  
Vol 7 (6) ◽  
pp. 71
Author(s):  
Daniele Masarone ◽  
Marina Verrengia ◽  
Ernesto Ammendola ◽  
Rita Gravino ◽  
Fabio Valente ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Β Blockers ◽  
Group 2 ◽  
Group 1

Clinical trials have shown the benefits of β-blockers therapy in patients with heart failure reduced ejection fraction. These benefits include improved survival and a reduced need for hospitalization. Cardiac resynchronization therapy has emerged as an essential device-based therapy for symptomatic patients with heart failure reduced ejection fraction despite optimal pharmacologic treatment. The extent to which β-blockers are being utilized in patients receiving cardiac resynchronization therapy is not well known. In this study, we evaluate the possibility of increasing β-blockers doses in an unselected cohort of heart failure reduced ejection patients after cardiac resynchronization therapy capable defibrillator system implantation and the correlation between β-blockers treatments and clinical outcome. Methods and results: Patients with heart failure reduced ejection fraction in β-blockers therapy that underwent cardiac resynchronization therapy capable defibrillator system implantation between July 2008, and December 2016 were enrolled in the study. The β-blockers dose was determined at the time of discharge and during follow-up. Cardiovascular mortality, hospitalization for worsening heart failure or arrhythmic storm and appropriate intervention of the device, were recorded. The study cohort included 480 patients, 289 patients (60.3%) had β-blockers doses equal to the dose before CRT (Group 1), 191 patients (39.7%) had higher β-blockers doses than those before the CRT implant (Group 2). Comparing the two groups, Group 2 have lower cardiovascular mortality, heart failure-related hospitalization, and arrhythmic events than Group 1. Conclusion: After initiating CRT, β-blockers could be safely up-titrated at higher doses with the reduction in mortality, heart failure-related hospitalization, and arrhythmic events.

ID: 10: FRAGMENTED QRS DOES NOT PREDICT ONSET OF HEART FAILURE WITH PRESERVED EJECTION FRACTION IN PATIENTS WITH DIASTOLIC DYSFUNCTION

2016 ◽  
Vol 64 (4) ◽  
pp. 922.1-922 ◽  
Author(s):  
I Karagodin ◽  
JL Strande ◽  
B Marong
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Adverse Outcomes ◽  
Preserved Ejection Fraction ◽  
Bundle Branch Block ◽  
Fragmented Qrs ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

BackgroundDepolarization and repolarization ECG abnormalities such as fragmented QRS and wide frontal QRS-T angles are associated with heart failure with preserved ejection fraction (HFpEF) and are associated with adverse outcomes. However, no studies have investigated whether these abnormalities are present in asymptomatic diastolic dysfunction and whether these abnormalities are predictive of the development of HFpEF in subjects with diastolic dysfunction. The goal of this study is to determine whether fQRS and widening of the QRS-T angle precedes the development of HFpEF in patients with diastolic dysfunction.MethodsThis retrospective cohort study included 100 subjects with diastolic dysfunction and an ejection fraction >50% as reported on transthoracic echocardiography (TTE) who were free of HF at baseline. We analyzed 12-lead ECGs to determine fQRS and frontal QRS-T angle. Patients with QRS>120 ms, bundle branch block pattern, or incomplete right bundle branch block were excluded. The subjects were divided into two groups: Group 1 (n=53) included subjects who were known to progress to HFpEF and Group 2 (n=47) included patients who remained asymptomatic.ResultsThere was no significant difference in the proportion of patients with fQRS in Group 1 compared to Group 2 (33/41 vs. 35/42, p=0.78). The difference was also not significant when comparing hypertensive patients in Group 1 versus Group 2 (28/35 vs. 24/30, p=1.0), as well as patients without hypertension in both groups (5/6 vs. 11/12, p=1.0). On average, the QRS-T angle was wider in Group 1 (64.6) compared to Group 2 (51.7).ConclusionIn patients with asymptomatic diastolic dysfunction, fragmented QRS is present in both patients who progress to HFpEF as well as patients who remain asymptomatic. This suggests that fragmented QRS is associated with diastolic dysfunction, but does not predict the development of heart failure symptoms. The frontal QRS-T angle may be a useful measurement in predicting which patients go on to develop HFpEF. However, larger prospective studies are needed to further investigate this relationship.

scholarly journals Comorbidities Associated with One-Year Mortality in Patients with Atrial Fibrillation and Heart Failure

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 830
Author(s):  
Ruxandra Nicoleta Horodinschi ◽  
Camelia Cristina Diaconu
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Heart failure (HF) and atrial fibrillation (AF) commonly coexist and patients with both diseases have a worse prognosis than those with HF or AF alone. The objective of our study was to identify the factors associated with one-year mortality in patients with HF and AF, depending on the left ventricular ejection fraction (LVEF). Methods: We included 727 patients with HF and AF consecutively admitted in a clinical emergency hospital between January 2018 and December 2019. The inclusion criteria were age of more than 18 years, diagnosis of chronic HF and AF (paroxysmal, persistent, permanent), and signed informed consent. The exclusion criteria were the absence of echocardiographic data, a suboptimal ultrasound view, and other cardiac rhythms than AF. The patients were divided into 3 groups: group 1 (337 patients with AF and HF with reduced ejection fraction (HFrEF)), group 2 (112 patients with AF and HF with mid-range ejection fraction (HFmrEF)), and group 3 (278 patients with AF and HF with preserved ejection fraction (HFpEF)). Results: The one-year mortality rates were 36.49% in group 1, 27.67% in group 2, and 27.69% in group 3. The factors that increased one-year mortality were chronic kidney disease (OR 2.35, 95% CI 1.45–3.83), coronary artery disease (OR 1.67, 95% CI 1.06–2.62), and diabetes (OR 1.66, 95% CI 1.05–2.67) in patients with HFrEF; and hypertension in patients with HFpEF (OR 2.45, 95% CI 1.36–4.39). Conclusions: One-year mortality in patients with HF and AF is influenced by different factors, depending on the LVEF.

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