Aortic stiffening precedes onset of heart failure with preserved ejection fraction in patients with asymptomatic diastolic dysfunction

BMC Cardiovascular Disorders

Research Article

Ilya Karagodin¹  Omer Aba-Omer¹  Jennifer L. Strande²  Rodney Sparapani³ 

[1]Department of Medicine, Medical College of Wisconsin, 9200 Wisconsin Ave, 53226, Milwaukee, WI, USA

[2]Department of Medicine, Medical College of Wisconsin, 9200 Wisconsin Ave, 53226, Milwaukee, WI, USA

[3]Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

[4]Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA

关键词: Heart Failure;    Heart Failure with Preserved Ejection Fraction (HFpEF);    Diabetes;    Echocardiography;    Cardiomyopathy;    Biomarker;   

DOI  :  10.1186/s12872-017-0490-9

 received in 2016-09-02, accepted in 2017-02-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIdentifying which patients with diastolic dysfunction will progress to heart failure with preserved ejection fraction (HFpEF) remains challenging. The goal of this study is to determine whether increased vascular stiffness as identified on 2D transthoracic echocardiography (TTE) serves as a biomarker for the development of HFpEF in patients with diastolic dysfunction.MethodsThe study design is a matched retrospective case–control study. Subjects with diastolic dysfunction were divided into two groups based on whether they had a clinical diagnosis of HFpEF. The two groups were matched based on age, gender, race and body surface area, resulting in 77 matched pairs (n = 154). Data from the first TTE that documented diastolic dysfunction prior to the development of HFpEF was extracted along with baseline demographic and clinical data. Indices of vascular stiffness were measured and compared. A sub-group analysis was performed to compare diabetic subjects in Group 1 (n = 43) to those in Group 2 (n = 21).ResultsGroup 1 had significantly decreased aortic distensibility as measured on the initial TTE when compared to Group 2 (1.9 ± 1.0 vs. 2.8 ± 1.8 cm2dyne−110−3, p = 0.01). In the diabetic subset, Group 1 had significantly less aortic strain (6.9 ± 3.3 vs. 9.7 ± 5.6%, p = 0.02) and aortic distensibility (1.8 ± 1.0 vs. 3.5 ± 2.6 cm2dyne−110−3, p = 0.02) compared to Group 2. Other indices of vascular stiffness did not differ significantly between groups.ConclusionsThis study demonstrates that increased proximal aortic stiffness is associated with the development of HFpEF in patients with asymptomatic diastolic dysfunction. Larger prospective studies are needed to further investigate this relationship.

【 授权许可】

CC BY   
© The Author(s). 2017