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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...

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Autores principales: 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.
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
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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.
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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
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