Abstract
Background Evidence continues to demonstrate increasing prevalence, cost, and mortality implications of heart failure with preserved ejection fraction (HFpEF), but clearly defined parameters that distinguish between control subjects and HFpEF have not been established. Objectives This study was designed to detect differences in markers associated with Ventricular-arterial coupling and HFpEF when comparing matched case and control groups. Methods A study cohort of case (incident patients with HFpEF; n = 155) and matched control (patients with no prior heart failure; n = 155) groups was retrospectively identified. Matching criteria included race, sex, age, and date of echocardiography (within 1 year). Physiologic and echocardiographic markers were collected from previously acquired transthoracic echocardiograms. These echocardiographic images were reanalyzed, and measures of ventricular-arterial coupling were calculated. Using conditional logistic regression and controlling for covariates, models were fitted to detect differences in HFpEF markers between case and control subjects. Results Statistically significant differences in markers that reflect ventricular elastance (Ees; P =.007) and left atrial diameter (LAdiam; P =.04) were detected when comparing the case and control groups. Conditional logistic regression analyses suggested a 40% higher odds of being in the case group with every 1-unit increase in Ees (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.10–1.79) and a 2.92 times higher odds of being in the case group for every 1 cm increase in LAdiam (OR 2.92, 95% CI 1.064–7.994). Conclusions Ees and LAdiam are easily measurable echocardiographic markers that may have a role in identifying and tracking the progression toward incident HFpEF without increasing cost or risk to the patient. Prospective studies are indicated to explore the use of Ees and LAdiam as predictors of impending HFpEF.
| Original language | English |
|---|---|
| Pages (from-to) | 659-665 |
| Number of pages | 7 |
| Journal | Journal of Cardiac Failure |
| Volume | 23 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2017 |
Bibliographical note
Publisher Copyright:© 2017 Elsevier Inc.
Funding
There are no disclosures for Drs Neelon and Crandell. Dr Lekavich reports grant funding from the National Institute of Nursing Research (NINR) of the National Institute of Health under award number T32NR007091 but is without conflict of interest. Dr Barksdale serves on the Board of Governors for the Patient-Centered Outcomes Research Institute (PCORI) but is without conflict of interest. Dr Wu reports grant funding from NINR (K23NR014489) but is without conflict of interest. Dr Velazquez reports grant funding from the National Heart, Lung, and Blood Institute, Alnylam Pharmaceuticals, Amgen, Novartis, and Pfizer and consulting services for Amgen, Expert Exchange, Merck and Co, Novartis, and New Century Health.
| Funders | Funder number |
|---|---|
| National Institutes of Health (NIH) | |
| National Heart, Lung, and Blood Institute (NHLBI) | |
| National Institute of Health National Institute of Nursing Research | T32NR007091, K23NR014489 |
| National Institute of Health National Institute of Nursing Research | |
| AMGen | |
| Pfizer | |
| Merck | |
| Novartis | |
| Patient-Centered Outcomes Research Institute | |
| Alnylam Pharmaceuticals | |
| State Administration of Foreign Experts Affairs | |
| Program for New Century Excellent Talents in University |
Keywords
- Heart failure with preserved ejection fraction (HFpEF)
- diastolic heart failure
- matched case-control
- ventricular-arterial coupling
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine