Tinnitus in elderly patients and prognosis of mild-to-moderate congestive heart failure: a cross-sectional study with a long-term extension of the clinical follow-up

BMC Medicine

Research Article

Ada Dormi¹  Claudio Borghi¹  Maddalena Veronesi¹  Elisa R Rinaldi¹  Arrigo FG Cicero¹  Eugenio R Cosentino¹  Maria C Rimondi²  Cristina Brandolini²  Antonio Pirodda² 

[1] Department of Internal Medicine, Internal Medicine Unit, Aging and Kidney Diseases, Bologna, Italy;Department of Surgical Sciences and Anesthesiology, Audiology Unit, Bologna, Italy;

关键词: Left Ventricular Ejection Fraction;    Chronic Heart Failure;    Left Ventricular Function;    Brain Natriuretic Peptide;    Brain Natriuretic Peptide Level;   

DOI  :  10.1186/1741-7015-9-80

 received in 2010-09-03, accepted in 2011-06-29,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe complex mechanism responsible for tinnitus, a symptom highly prevalent in elderly patients, could involve an impaired control of the microcirculation of the inner ear, particularly in patients with poor blood pressure control and impaired left ventricular (LV) function.MethodsIn order to define the relationship between the presence of tinnitus and the severity and clinical prognosis of mild-to-moderate chronic heart failure (CHF) in a large population of elderly patients (N = 958), a cross-sectional study was conducted with a long-term extension of the clinical follow-up. Blood pressure, echocardiographic parameters, brain natriuretic peptide (BNP), hospitalization, and mortality for CHF were measured. Multivariate logistic regression analysis was used to assess the association between the presence of tinnitus and some of the prognostic determinants of heart failure.ResultsThe presence of tinnitus was ascertained in 233 patients (24.3%; mean age 74.9 ± 6 years) and was associated with reduced systolic and diastolic blood pressure (123.1 ± 16/67.8 ± 9 vs 125.9 ± 15/69.7 ± 9; P = .027/P = .006), reduced LV ejection fraction (LVEF%; 43.6 ± 15 vs 47.9 ± 14%, P = .001), and increased BNP plasma levels (413.1 ± 480 vs 286.2 ± 357, P = .013) in comparison to patients without symptoms. The distribution of CHF functional class was shifted toward a greater severity of the disease in patients with tinnitus. Combined one-year mortality and hospitalization for CHF (events/year) was 1.43 ± 0.2 in patients with tinnitus and 0.83 ± 0.1 in patients without tinnitus, with an adjusted hazard ratio (HR) of 0.61 (95% confidence interval (CI): 0.37 to 0.93, P <.002).ConclusionsOur preliminary data indirectly support the hypothesis that tinnitus is associated with a worse CHF control in elderly patients and can have some important clinical implications for the early identification of patients who deserve a more aggressive management of CHF.

【 授权许可】

CC BY   
© Borghi et al; licensee BioMed Central Ltd. 2011