Cargando…
Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction
AIMS: The aim of this study is to determine factors associated with long‐term recovery of left ventricular ejection fraction (LVEF) in patients with heart failure with reduced EF (HFrEF) and if further recovery also occurs in this group. METHODS AND RESULTS: Among 621 participants enrolled in the Al...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524210/ https://www.ncbi.nlm.nih.gov/pubmed/32592541 http://dx.doi.org/10.1002/ehf2.12863 |
_version_ | 1783588512781565952 |
---|---|
author | Howlett, Jonathan G. Sharma, Nakul Alemayehu, Wendimagegn G. Dyck, Jason R.B. Anderson, Todd Fine, Nowell Becker, Harald White, James A. Paterson, D. Ian Thompson, Richard B. Oudit, Gavin Y. Haykowsky, Mark J. Ezekowitz, Justin A. |
author_facet | Howlett, Jonathan G. Sharma, Nakul Alemayehu, Wendimagegn G. Dyck, Jason R.B. Anderson, Todd Fine, Nowell Becker, Harald White, James A. Paterson, D. Ian Thompson, Richard B. Oudit, Gavin Y. Haykowsky, Mark J. Ezekowitz, Justin A. |
author_sort | Howlett, Jonathan G. |
collection | PubMed |
description | AIMS: The aim of this study is to determine factors associated with long‐term recovery of left ventricular ejection fraction (LVEF) in patients with heart failure with reduced EF (HFrEF) and if further recovery also occurs in this group. METHODS AND RESULTS: Among 621 participants enrolled in the Alberta Heart Failure Etiology and Analysis Team (HEART) Study, 316 with Stage C HF underwent comprehensive imaging and biomarker testing at enrolment and at 1‐year follow up. Using pre‐enrolment data, HF with recovered EF (HFrecEF) was defined as an absolute improvement ≥5% in LVEF from the prior lowest LVEF value, with a final LVEF value > 35% at or prior to study baseline. Participants with all LVEF > 40% were included for comparison. Hospitalization‐free survival to 5 years was performed. The median cohort age was 66 years, and time from diagnosis was 4 years; 82% were male patients. Of the 316 patients, 95 (30%) patients had HFrecEF and 56 (18%) patients pHFrEF. On multivariate analysis, only shorter duration of HF was predictive of HFrecEF status. Over 1 year, LVEF increased in the HFrecEF group 4.0% (0.15–7.90, P = 0.042) as compared with persistent HFrEF, who in turn demonstrated higher baseline serum high sensitivity Troponin‐T with further increase at follow up 0.55(0.33–0.86, P = 0.011). No change in any parameter in the HFpEF/HFmrEF group at follow up was observed. CONCLUSIONS: Patients with HFrecEF demonstrate evidence of additional late improvement in LVEF and unchanged troponin levels, in contrast to those with persistent HFrEF, where LVEF does not improve and serum troponin rises over time. These data help to inform mechanisms relating to late LV remodelling. |
format | Online Article Text |
id | pubmed-7524210 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75242102020-10-02 Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction Howlett, Jonathan G. Sharma, Nakul Alemayehu, Wendimagegn G. Dyck, Jason R.B. Anderson, Todd Fine, Nowell Becker, Harald White, James A. Paterson, D. Ian Thompson, Richard B. Oudit, Gavin Y. Haykowsky, Mark J. Ezekowitz, Justin A. ESC Heart Fail Original Research Articles AIMS: The aim of this study is to determine factors associated with long‐term recovery of left ventricular ejection fraction (LVEF) in patients with heart failure with reduced EF (HFrEF) and if further recovery also occurs in this group. METHODS AND RESULTS: Among 621 participants enrolled in the Alberta Heart Failure Etiology and Analysis Team (HEART) Study, 316 with Stage C HF underwent comprehensive imaging and biomarker testing at enrolment and at 1‐year follow up. Using pre‐enrolment data, HF with recovered EF (HFrecEF) was defined as an absolute improvement ≥5% in LVEF from the prior lowest LVEF value, with a final LVEF value > 35% at or prior to study baseline. Participants with all LVEF > 40% were included for comparison. Hospitalization‐free survival to 5 years was performed. The median cohort age was 66 years, and time from diagnosis was 4 years; 82% were male patients. Of the 316 patients, 95 (30%) patients had HFrecEF and 56 (18%) patients pHFrEF. On multivariate analysis, only shorter duration of HF was predictive of HFrecEF status. Over 1 year, LVEF increased in the HFrecEF group 4.0% (0.15–7.90, P = 0.042) as compared with persistent HFrEF, who in turn demonstrated higher baseline serum high sensitivity Troponin‐T with further increase at follow up 0.55(0.33–0.86, P = 0.011). No change in any parameter in the HFpEF/HFmrEF group at follow up was observed. CONCLUSIONS: Patients with HFrecEF demonstrate evidence of additional late improvement in LVEF and unchanged troponin levels, in contrast to those with persistent HFrEF, where LVEF does not improve and serum troponin rises over time. These data help to inform mechanisms relating to late LV remodelling. John Wiley and Sons Inc. 2020-06-27 /pmc/articles/PMC7524210/ /pubmed/32592541 http://dx.doi.org/10.1002/ehf2.12863 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Articles Howlett, Jonathan G. Sharma, Nakul Alemayehu, Wendimagegn G. Dyck, Jason R.B. Anderson, Todd Fine, Nowell Becker, Harald White, James A. Paterson, D. Ian Thompson, Richard B. Oudit, Gavin Y. Haykowsky, Mark J. Ezekowitz, Justin A. Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title | Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title_full | Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title_fullStr | Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title_full_unstemmed | Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title_short | Circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
title_sort | circulating troponin and further left ventricular ejection fraction improvement in patients with previously recovered left ventricular ejection fraction |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524210/ https://www.ncbi.nlm.nih.gov/pubmed/32592541 http://dx.doi.org/10.1002/ehf2.12863 |
work_keys_str_mv | AT howlettjonathang circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT sharmanakul circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT alemayehuwendimagegng circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT dyckjasonrb circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT andersontodd circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT finenowell circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT beckerharald circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT whitejamesa circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT patersondian circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT thompsonrichardb circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT ouditgaviny circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT haykowskymarkj circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction AT ezekowitzjustina circulatingtroponinandfurtherleftventricularejectionfractionimprovementinpatientswithpreviouslyrecoveredleftventricularejectionfraction |