Left atrial pressure overload and prognosis in elderly patients with heart failure and preserved ejection fraction: a prospective multicenter observational study.
adult cardiology
clinical physiology
geriatric medicine
heart failure
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
30 09 2021
30 09 2021
Historique:
entrez:
1
10
2021
pubmed:
2
10
2021
medline:
21
10
2021
Statut:
epublish
Résumé
The severity of diastolic dysfunction is assessed using a combination of several indices of left atrial (LA) volume overload and LA pressure overload. We aimed to clarify which overload is more associated with the prognosis in patients with heart failure and preserved ejection fraction (HFpEF). A prospective, multicenter observational registry of collaborating hospitals in Osaka, Japan. We enrolled hospitalised patients with HFpEF showing sinus rhythm (men, 79; women, 113). Blood tests and transthoracic echocardiography were performed before discharge. The ratio of diastolic elastance (Ed) to arterial elastance (Ea) was used as a relative index of LA pressure overload. All-cause mortality and admission for heart failure were evaluated at >1 year after discharge. In the multivariable Cox regression analysis, Ed/Ea, but not LA volume index, was significantly associated with all-cause mortality or admission for heart failure (HR 2.034, 95% CI 1.059 to 3.907, p=0.032), independent of age, sex, and the serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level. In patients with a higher NT-proBNP level, the effect of higher Ed/Ea on prognosis was prominent (p=0.015). Ed/Ea, an index of LA pressure overload, was significantly associated with the prognosis in elderly patients with HFpEF showing sinus rhythm. UMIN000021831.
Identifiants
pubmed: 34593483
pii: bmjopen-2020-044605
doi: 10.1136/bmjopen-2020-044605
pmc: PMC8487200
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e044605Investigateurs
Shunsuke Tamaki
(S)
Masatake Fukunami
(M)
Takaharu Hayashi
(T)
Masaharu Masuda
(M)
Mitsutoshi Asai
(M)
Toshiaki Mano
(T)
Daisaku Masuda
(D)
Yoshihiro Takeda
(Y)
Yoshiyuki Nagai
(Y)
Shizuya Yamashita
(S)
Masami Sairyo
(M)
Shuichi Nozaki
(S)
Yasunori Ueda
(Y)
Masaaki Uematsu
(M)
Yukihiro Koretsune
(Y)
Kunihiko Nagai
(K)
Masamichi Yano
(M)
Masami Nishino
(M)
Jun Tanouchi
(J)
Yoh Arita
(Y)
Shinji Hasegawa
(S)
Takamaru Ishizu
(T)
Minoru Ichikawa
(M)
Yuzuru Takano
(Y)
Eisai Rin
(E)
Tetsuya Watanabe
(T)
Masahiro Izumi
(M)
Hiroyoshi Yamamoto
(H)
Hiroyasu Kato
(H)
Kazuhiro Nakatani
(K)
Hisatoyo Hiraoka
(H)
Mayu Nishio
(M)
Keiji Hirooka
(K)
Takahiro Yoshimura
(T)
Yoshinori Yasuoka
(Y)
Akihiro Tani
(A)
Yasushi Okumoto
(Y)
Hideharu Akagi
(H)
Yasunaka Makino
(Y)
Toshinari Ohnishi
(T)
Katsuomi Iwakura
(K)
Nagahiro Nishikawa
(N)
Yoshiyuki Kijima
(Y)
Takashi Kitao
(T)
Hideyuki Kanai
(H)
Wataru Shioyama
(W)
Masashi Fujita
(M)
Koichiro Harada
(K)
Masahiro Kumada
(M)
Osamu Nakagawa
(O)
Ryo Araki
(R)
Takayuki Yamada
(T)
Akito Nakagawa
(A)
Fusako Sera
(F)
Kei Nakamoto
(K)
Hidetaka Kioka
(H)
Tomohito Ohtani
(T)
Katsuki Okada
(K)
Hiroya Mizuno
(H)
Tomoharu Dohi
(T)
Takayuki Kojima
(T)
Hirota Kida
(H)
Akihiro Sunaga
(A)
Oeun Bolrathanak
(O)
Shinichiro Suna
(S)
Toshihiro Takeda
(T)
Yasushi Matsumura
(Y)
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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