Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis

JOURNAL OF CARDIAC FAILURE

卷:23

Article

Lekavich, Carolyn L.¹  Barksdale, Debra J.²  Wu, Jia-Rong³  Neelon, Virginia⁴  Crandell, Jamie^3,5  Velazquez, Eric S.⁶ 

[1] Duke Univ, Div Cardiovasc Med, Med Ctr, Durham, NC 27710 USA

[2] Virginia Commonwealth Univ, Sch Nursing, Richmond, VA USA

[3] Univ N Carolina, Sch Nursing, Chapel Hill, NC USA

[4] Univ N Carolina, Sch Nursing, Biobehav Lab, Chapel Hill, NC USA

[5] Univ North Carolina Chapel Hill, Dept Biostat, Chapel Hill, NC USA

[6] Duke Univ, Med Ctr, Duke Clin Res Inst, Div Cardiovasc Med, Durham, NC 27710 USA

关键词: Heart failure with preserved ejection fraction (HFpEF);    diastolic heart failure;    matched case-control;    ventricular-arterial coupling;   

DOI  :  10.1016/j.cardfail.2017.07.395

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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