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Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study

OBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participant...

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Autores principales: Taylor, Clare J, Roalfe, Andrea K, Tait, Lynda, Davis, Russell C, Iles, Rachel, Derit, Marites, Hobbs, F D Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120315/
https://www.ncbi.nlm.nih.gov/pubmed/25015472
http://dx.doi.org/10.1136/bmjopen-2014-005256
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author Taylor, Clare J
Roalfe, Andrea K
Tait, Lynda
Davis, Russell C
Iles, Rachel
Derit, Marites
Hobbs, F D Richard
author_facet Taylor, Clare J
Roalfe, Andrea K
Tait, Lynda
Davis, Russell C
Iles, Rachel
Derit, Marites
Hobbs, F D Richard
author_sort Taylor, Clare J
collection PubMed
description OBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participants from the original Echocardiographic Heart of England Screening (ECHOES) study were invited to attend for rescreening. OUTCOME MEASURES: Prevalence of heart failure at rescreening overall and for each original ECHOES subgroup. Test performance of N Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels at different thresholds for screening. RESULTS: 1618 of 3408 participants underwent screening which represented 47% of survivors and 26% of the original ECHOES cohort. A total of 176 (11%, 95% CI 9.4% to 12.5%) participants were classified as having heart failure at rescreening; 103 had heart failure with reduced ejection fraction (HFREF) and 73 had heart failure with preserved ejection fraction (HFPEF). Sixty-eight out of 1232 (5.5%, 95% CI 4.3% to 6.9%) participants who were recruited from the general population over the age of 45 and did not have heart failure in the original study, had heart failure on rescreening. An NT-proBNP cut-off of 400 pg/mL had sensitivity for a diagnosis of heart failure of 79.5% (95% CI 72.4% to 85.5%) and specificity of 87% (95% CI 85.1% to 88.8%). CONCLUSIONS: Rescreening identified new cases of HFREF and HFPEF. Progression to heart failure poses a significant threat over time. The natriuretic peptide cut-off level for ruling out heart failure must be low enough to ensure cases are not missed at screening.
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spelling pubmed-41203152014-08-05 Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study Taylor, Clare J Roalfe, Andrea K Tait, Lynda Davis, Russell C Iles, Rachel Derit, Marites Hobbs, F D Richard BMJ Open Cardiovascular Medicine OBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participants from the original Echocardiographic Heart of England Screening (ECHOES) study were invited to attend for rescreening. OUTCOME MEASURES: Prevalence of heart failure at rescreening overall and for each original ECHOES subgroup. Test performance of N Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels at different thresholds for screening. RESULTS: 1618 of 3408 participants underwent screening which represented 47% of survivors and 26% of the original ECHOES cohort. A total of 176 (11%, 95% CI 9.4% to 12.5%) participants were classified as having heart failure at rescreening; 103 had heart failure with reduced ejection fraction (HFREF) and 73 had heart failure with preserved ejection fraction (HFPEF). Sixty-eight out of 1232 (5.5%, 95% CI 4.3% to 6.9%) participants who were recruited from the general population over the age of 45 and did not have heart failure in the original study, had heart failure on rescreening. An NT-proBNP cut-off of 400 pg/mL had sensitivity for a diagnosis of heart failure of 79.5% (95% CI 72.4% to 85.5%) and specificity of 87% (95% CI 85.1% to 88.8%). CONCLUSIONS: Rescreening identified new cases of HFREF and HFPEF. Progression to heart failure poses a significant threat over time. The natriuretic peptide cut-off level for ruling out heart failure must be low enough to ensure cases are not missed at screening. BMJ Publishing Group 2014-07-11 /pmc/articles/PMC4120315/ /pubmed/25015472 http://dx.doi.org/10.1136/bmjopen-2014-005256 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Cardiovascular Medicine
Taylor, Clare J
Roalfe, Andrea K
Tait, Lynda
Davis, Russell C
Iles, Rachel
Derit, Marites
Hobbs, F D Richard
Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title_full Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title_fullStr Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title_full_unstemmed Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title_short Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
title_sort observational longitudinal cohort study to determine progression to heart failure in a screened community population: the echocardiographic heart of england screening extension (echoes-x) study
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120315/
https://www.ncbi.nlm.nih.gov/pubmed/25015472
http://dx.doi.org/10.1136/bmjopen-2014-005256
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