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Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction

CONTEXT: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome associated with diastolic function abnormalities. It remains unclear which factors, if any, can predict the transition from asymptomatic diastolic dysfunction to an overt symptomatic phase. MATERIALS AND METHODS:...

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Autores principales: Issa, Omar, Peguero, Julio G., Podesta, Carlos, Diaz, Denisse, De La Cruz, Javier, Pirela, Daniela, Brenes, Juan Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353466/
https://www.ncbi.nlm.nih.gov/pubmed/28465981
http://dx.doi.org/10.4103/2211-4122.199064
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author Issa, Omar
Peguero, Julio G.
Podesta, Carlos
Diaz, Denisse
De La Cruz, Javier
Pirela, Daniela
Brenes, Juan Carlos
author_facet Issa, Omar
Peguero, Julio G.
Podesta, Carlos
Diaz, Denisse
De La Cruz, Javier
Pirela, Daniela
Brenes, Juan Carlos
author_sort Issa, Omar
collection PubMed
description CONTEXT: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome associated with diastolic function abnormalities. It remains unclear which factors, if any, can predict the transition from asymptomatic diastolic dysfunction to an overt symptomatic phase. MATERIALS AND METHODS: Patients hospitalized with suspected heart failure between January 2012 and November 2014 with a transthoracic echocardiogram demonstrating preserved systolic function were screened (n = 425). Patients meeting the American College of Cardiology Foundation/American Heart Association definition for HFpEF (n = 40) were matched in a 1:1 fashion to individuals admitted for hypertensive urgency with diastolic dysfunction and neither pulmonary edema nor history of heart failure (n = 40). The clinical records and echocardiograms of all eighty patients included in this retrospective study were reviewed. RESULTS: Patients with HFpEF had higher body mass index (BMI), creatinine, beta-blocker use, and Grade 2 diastolic dysfunction when compared to the hypertensive control population. Echocardiographic analysis demonstrated higher right ventricular systolic pressures, left ventricular mass index, E/A, and E/e’ in patients with HFpEF. Similarly, differences were observed in most left atrial (LA) parameters including larger LA maximum and minimum volume indices, as well as smaller LA-emptying fractions in the heart failure group. Multivariate logistic regression analysis revealed LA minimum volume index (odds ratio [OR]: 1.23 [1.09–1.38], P = 0.001) to have the strongest association with heart failure hospitalization after adjustment for creatinine (OR: 7.09 [1.43–35.07], P = 0.016) and BMI (OR: 1.11 [0.99–1.25], P = 0.074). CONCLUSION: LA minimum volume index best correlated with HFpEF in this patient cohort with diastolic dysfunction.
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spelling pubmed-53534662017-05-02 Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction Issa, Omar Peguero, Julio G. Podesta, Carlos Diaz, Denisse De La Cruz, Javier Pirela, Daniela Brenes, Juan Carlos J Cardiovasc Echogr Original Article CONTEXT: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome associated with diastolic function abnormalities. It remains unclear which factors, if any, can predict the transition from asymptomatic diastolic dysfunction to an overt symptomatic phase. MATERIALS AND METHODS: Patients hospitalized with suspected heart failure between January 2012 and November 2014 with a transthoracic echocardiogram demonstrating preserved systolic function were screened (n = 425). Patients meeting the American College of Cardiology Foundation/American Heart Association definition for HFpEF (n = 40) were matched in a 1:1 fashion to individuals admitted for hypertensive urgency with diastolic dysfunction and neither pulmonary edema nor history of heart failure (n = 40). The clinical records and echocardiograms of all eighty patients included in this retrospective study were reviewed. RESULTS: Patients with HFpEF had higher body mass index (BMI), creatinine, beta-blocker use, and Grade 2 diastolic dysfunction when compared to the hypertensive control population. Echocardiographic analysis demonstrated higher right ventricular systolic pressures, left ventricular mass index, E/A, and E/e’ in patients with HFpEF. Similarly, differences were observed in most left atrial (LA) parameters including larger LA maximum and minimum volume indices, as well as smaller LA-emptying fractions in the heart failure group. Multivariate logistic regression analysis revealed LA minimum volume index (odds ratio [OR]: 1.23 [1.09–1.38], P = 0.001) to have the strongest association with heart failure hospitalization after adjustment for creatinine (OR: 7.09 [1.43–35.07], P = 0.016) and BMI (OR: 1.11 [0.99–1.25], P = 0.074). CONCLUSION: LA minimum volume index best correlated with HFpEF in this patient cohort with diastolic dysfunction. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5353466/ /pubmed/28465981 http://dx.doi.org/10.4103/2211-4122.199064 Text en Copyright: © 2017 Journal of Cardiovascular Echography http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Issa, Omar
Peguero, Julio G.
Podesta, Carlos
Diaz, Denisse
De La Cruz, Javier
Pirela, Daniela
Brenes, Juan Carlos
Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title_full Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title_fullStr Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title_full_unstemmed Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title_short Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction
title_sort left atrial size and heart failure hospitalization in patients with diastolic dysfunction and preserved ejection fraction
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353466/
https://www.ncbi.nlm.nih.gov/pubmed/28465981
http://dx.doi.org/10.4103/2211-4122.199064
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