Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure
| Autor: | Simon Stewart, Michele McGrady, Louise Shiel, Jennifer M Coller, David L. Prior, Danny Liew, Duncan J. Campbell, Henry Krum, Fei Fei Gong, Christopher M. Reid, Alice J. Owen |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Systolic abnormality Lower risk Asymptomatic Internal medicine Medicine Diseases of the circulatory (Cardiovascular) system Humans Prospective Studies Structural abnormality Heart Failure Ejection fraction business.industry valvular heart disease Atrial fibrillation Stroke Volume Original Articles Middle Aged medicine.disease Diastolic abnormality Pulse pressure Blood pressure Risk factors Echocardiography Heart failure RC666-701 Cardiology Original Article medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | ESC Heart Failure ESC Heart Failure, Vol 9, Iss 1, Pp 196-212 (2022) |
| ISSN: | 2055-5822 |
| Popis: | Aims Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure (HF) may provide insight into early mechanisms of HF pathogenesis. We examined risk factors associated with asymptomatic echocardiographic structural, systolic, and diastolic abnormalities, separately and in combination, and interactions between risk factors, in the prospective community‐based SCReening Evaluation of the Evolution of New HF (SCREEN‐HF) Study cohort of 3190 participants at increased risk of cardiovascular disease. Methods and results Inclusion criteria were age ≥ 60 years with one or more of hypertension, diabetes, ischaemic heart disease, valvular heart disease, abnormal heart rhythm, cerebrovascular disease, or renal impairment. Exclusion criteria were known HF, ejection fraction mild valve abnormality. Structural, systolic, and diastolic echocardiographic abnormalities were defined according to the Atherosclerosis Risk in Communities study criteria, and risk factors for asymptomatic structural, systolic, and diastolic abnormalities were identified using logistic regression analysis. In multivariable analysis, increased body mass index (BMI), non‐steroidal anti‐inflammatory drug therapy, and alcohol intake were risk factors for isolated structural abnormality, whereas male gender, increased heart rate, atrial fibrillation (AF), angiotensin‐converting enzyme inhibitor therapy, and obstructive sleep apnoea were associated with a lower risk. Moreover, male gender, smoking, increased systolic blood pressure, and physical inactivity were risk factors for isolated systolic abnormality, whereas increased pulse pressure and antihypertensive therapy were associated with a lower risk. Furthermore, increased age, blood pressure, amino‐terminal pro‐B‐type natriuretic peptide level, and warfarin therapy (associated with AF) were risk factors for isolated diastolic abnormality, whereas increased heart rate and triglyceride level (associated with BMI) were associated with a lower risk. The association of increased heart rate with lower risk of structural and diastolic abnormalities was independent of β‐blocker therapy. Interactions between risk factors differed for structural, systolic, and diastolic abnormalities. Conclusions The different risk factors for asymptomatic structural, systolic, and diastolic abnormalities that predict symptomatic HF, and the interactions between risk factors, illustrate how these structural, systolic, and diastolic abnormalities represent unique trajectories that lead to symptomatic HF. Improved understanding of these trajectories may assist in the design of HF prevention strategies. |
| Databáze: | OpenAIRE |
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