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Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study
AIMS: Abnormal left ventricular diastolic response to preload stress can be an early marker of heart failure (HF). The aim of this study was to assess clinical course in patients with HF with preserved ejection fraction (HFpEF) who underwent preload stress echocardiography. In the subgroup analysis,...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773745/ https://www.ncbi.nlm.nih.gov/pubmed/36017722 http://dx.doi.org/10.1002/ehf2.14127 |
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author | Kusunose, Kenya Yamada, Hirotsugu Saijo, Yoshihito Nishio, Susumu Hirata, Yukina Ise, Takayuki Yamaguchi, Koji Fukuda, Daiju Yagi, Shusuke Soeki, Takeshi Wakatsuki, Tetsuzo Sata, Masataka |
author_facet | Kusunose, Kenya Yamada, Hirotsugu Saijo, Yoshihito Nishio, Susumu Hirata, Yukina Ise, Takayuki Yamaguchi, Koji Fukuda, Daiju Yagi, Shusuke Soeki, Takeshi Wakatsuki, Tetsuzo Sata, Masataka |
author_sort | Kusunose, Kenya |
collection | PubMed |
description | AIMS: Abnormal left ventricular diastolic response to preload stress can be an early marker of heart failure (HF). The aim of this study was to assess clinical course in patients with HF with preserved ejection fraction (HFpEF) who underwent preload stress echocardiography. In the subgroup analysis, we assessed the prognosis of patients with unstable signs during preload stress classified by treatment strategies. METHODS AND RESULTS: We prospectively conducted preload stress echocardiographic studies between January 2006 and December 2013 in 211 patients with HFpEF. Fifty‐eight patients had abnormal diastolic reserve during preload stress (unstable impaired relaxation: unstable IR). Of 58 patients with unstable IR, 19 patients were assigned to additional therapy by increased or additional therapy and 39 patients were assigned to standard therapy. Composite outcomes were prespecified as the primary endpoint of death and hospitalization for deteriorating HF. During a median period of 6.9 years, 19 patients (33%) reached the composite outcome. Unstable group with standard therapy had significantly shorter event‐free survival than stable group. Patients with uptitration of therapy had longer event‐free survival than those with standard therapy group after adjustment of laboratory data (hazard ratio, 0.20, 95% confidence interval, 0.05–0.90; P = 0.036); the 10 year event‐free survival in patients with and without uptitration of therapy was 93% and 51%, respectively (P = 0.023). CONCLUSIONS: Patients with unstable sign had significantly shorter event‐free survival than patients with stable sign. After additional therapy, the prognosis of patients with unstable signs improved. This technique may impact decision‐making for improving their prognosis. |
format | Online Article Text |
id | pubmed-9773745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97737452022-12-23 Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study Kusunose, Kenya Yamada, Hirotsugu Saijo, Yoshihito Nishio, Susumu Hirata, Yukina Ise, Takayuki Yamaguchi, Koji Fukuda, Daiju Yagi, Shusuke Soeki, Takeshi Wakatsuki, Tetsuzo Sata, Masataka ESC Heart Fail Original Articles AIMS: Abnormal left ventricular diastolic response to preload stress can be an early marker of heart failure (HF). The aim of this study was to assess clinical course in patients with HF with preserved ejection fraction (HFpEF) who underwent preload stress echocardiography. In the subgroup analysis, we assessed the prognosis of patients with unstable signs during preload stress classified by treatment strategies. METHODS AND RESULTS: We prospectively conducted preload stress echocardiographic studies between January 2006 and December 2013 in 211 patients with HFpEF. Fifty‐eight patients had abnormal diastolic reserve during preload stress (unstable impaired relaxation: unstable IR). Of 58 patients with unstable IR, 19 patients were assigned to additional therapy by increased or additional therapy and 39 patients were assigned to standard therapy. Composite outcomes were prespecified as the primary endpoint of death and hospitalization for deteriorating HF. During a median period of 6.9 years, 19 patients (33%) reached the composite outcome. Unstable group with standard therapy had significantly shorter event‐free survival than stable group. Patients with uptitration of therapy had longer event‐free survival than those with standard therapy group after adjustment of laboratory data (hazard ratio, 0.20, 95% confidence interval, 0.05–0.90; P = 0.036); the 10 year event‐free survival in patients with and without uptitration of therapy was 93% and 51%, respectively (P = 0.023). CONCLUSIONS: Patients with unstable sign had significantly shorter event‐free survival than patients with stable sign. After additional therapy, the prognosis of patients with unstable signs improved. This technique may impact decision‐making for improving their prognosis. John Wiley and Sons Inc. 2022-08-26 /pmc/articles/PMC9773745/ /pubmed/36017722 http://dx.doi.org/10.1002/ehf2.14127 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://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 Articles Kusunose, Kenya Yamada, Hirotsugu Saijo, Yoshihito Nishio, Susumu Hirata, Yukina Ise, Takayuki Yamaguchi, Koji Fukuda, Daiju Yagi, Shusuke Soeki, Takeshi Wakatsuki, Tetsuzo Sata, Masataka Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title | Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title_full | Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title_fullStr | Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title_full_unstemmed | Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title_short | Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
title_sort | clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773745/ https://www.ncbi.nlm.nih.gov/pubmed/36017722 http://dx.doi.org/10.1002/ehf2.14127 |
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