Characteristics and Outcomes of Hospitalized Patients With Heart Failure and Reduced vs Preserved Ejection Fraction

Tsuchihashi-Makaya, Miyuki; Hamaguchi, Sanae; Kinugawa, Shintaro; Yokota, Takashi; Goto, Daisuke; Yokoshiki, Hisashi; Kato, Norihiro; Takeshita, Akira; Tsutsui, Hiroyuki; Investigators, Jcare-Card

doi:10.1253/circj.cj-09-73-1203

Cited by 53 publications

(71 citation statements)

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“…4) In the present study, rehospitalization due to worsening HF occurred with cumulative rates of rehospitalization of 17.5% at 1 year, 21.4% at 2 years, and 25.5% at 3 years, findings that are in agreement with a previous Japanese study.…”

Section: Discussionsupporting

confidence: 93%

“…Some large registries focused on the prognosis of Japanese HF patients and reported determinant factors for all-cause or cardiovascular mortality. 4,5) However, there are limited data regarding the predictors of rehospitalization due to worsening HF. 6) Interestingly, the prognostic determinants for HF rehospitalization seem to be not similar to those for mortality.…”

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confidence: 99%

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Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

et al. 2015

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SummaryRepeated hospitalization due to acute decompensated heart failure (HF) is a pandemic health problem in Japan. However, it is difficult to predict rehospitalization after discharge for acute decompensated HF. We used a single hospital-based cohort from the Shinken Database 2004Database -2012 who visited the Cardiovascular Institute Hospital. A total of 282 patients discharged after their first acute HF admission were included in the analysis. The median follow-up period was 908 ± 865 days. Of these patients, rehospitalization due to worsening HF occurred in 55 patients. The cumulative rate of rehospitalization was 17.5% at 1 year, 21.4% at 2 years, and 25.5% at 3 years. Patients with rehospitalization were older than those without rehospitalization. Prevalence of diabetes mellitus (DM) was more common in patients with rehospitalization. Average heart rate (HR) tended to be higher in patients with rehospitalization. Loop diuretics were more commonly used at hospital discharge in patients with rehospitalization. Multivariate Cox regression analysis revealed that age ≥ 75 years, DM, HR ≥ 75 bpm at discharge, and use of loop diuretics at discharge were independent predictors for rehospitalization. The number of these independent risk factors could be used to clearly discriminate between the HF rehospitalization low-, middle-and high-risk patients. HF rehospitalization commonly occurred in patients who were discharged after their first acute HF admission. Older age, DM, increased HR, and loop diuretics use at discharge were independently associated with HF rehospitalization. By simply counting these risk factors, we might be able to predict the risk of HF rehospitalization after discharge. (Int Heart J 2015; 56: 219-225)

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

et al. 2015

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“…This is called HF with preserved ejection fraction (HFpEF) and is thought to be mainly caused by LV diastolic dysfunction. [1][2][3][4] Various factors, including aging, hypertension, diabetes mellitus, chronic kidney disease, metabolic syndrome, and arterial stiffness are considered causes of LV diastolic dysfunction and can be important in the development of HFpEF. 5,6) The development of arterial stiffness in HF patients was reported to correlate with poor prognosis; therefore, assessment and management of arterial stiffness are important.…”

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Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease

et al. 2016

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SummaryLeft ventricular (LV) diastolic dysfunction is considered the main cause of heart failure with preserved ejection fraction (HFpEF). There have been few reports on the correlation between LV diastolic dysfunction and arterial stiffness in patients with clinical cardiovascular disease.This cross-sectional study enrolled 100 patients (67 men, 33 women; mean age, 70 years). All participants were diagnosed with cardiovascular disease. A total of 89 (89%) patients had coronary artery disease or HF. Patients with reduced EF and valvular disease were excluded. Arterial stiffness was assessed by the cardio-ankle vascular index (CAVI), and LV diastolic dysfunction was estimated using echocardiography. The patients were divided into two groups based on the median value of CAVI. In all patients the ratio of early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e') was significantly higher in the high CAVI group than in the low CAVI group (15.5 ± 6.4 versus 12.5 ± 2.9, P = 0.003). In the HF subgroup, E/e' was also significantly higher in the high CAVI group than in the low CAVI group (17.2 ± 5.9 versus 13.0 ± 3.1, P = 0.026). In univariate regression analysis, CAVI was significantly associated with E/e' in all patients (β = 0.28, P = 0.004) and in HF patients (β = 0.4, P = 0.028). Also in multivariate analysis, CAVI remained as an independent predictive factor of E/e' (β = 0.252, P = 0.037).A high CAVI was independently associated with LV diastolic dysfunction in patients with clinical cardiovascular disease. These results suggested that arterial stiffness contributed to the development of LV diastolic dysfunction. (Int Heart J 2016; 57: 729-735)

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“…Vol 56 No 2 COMBINATION OF NUTRITIONAL ASSESSMENTS IN ADHF expected to observe severe malnutrition if an HF patient who was malnourished or at risk by MNA had low TTR. Thus, we assumed these patients had a poor prognosis.…”

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Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

et al. 2015

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SummaryDecreased Transthyretin (TTR) can be observed in heart failure patients with malnutrition evaluated by the Mini Nutritional Assessment (MNA). This study investigated whether a combination of different nutritional assessment methods would be useful for assessing prognosis in patients with acute decompensated heart failure (ADHF).This prospective study included 52 patients with ADHF (mean age, 71.1 ± 14.7 years; men 55.8%) who were admitted to our hospital between June 2012 and August 2013. On admission, nutritional status was evaluated according to levels of TTR and the MNA. Of 52 patients, 28 (53.8%) had TTR < 15 mg/dL, 39 (75.0%) had malnutrition or were at risk of malnutrition (MNA score ≤ 23.5), and 21 (40.4%) were categorized into group L (MNA score ≤ 23.5 and TTR < 15 mg/dL). Readmission due to worsening heart failure occurred in 12 patients (23.1%), and there were 4 (7.7%) allcause deaths. The 1-year event-free survival rates in group L and the remaining patients (group O) were 27.7% and 85.6%, respectively (P = 0.001). Using Cox multivariate analysis, group L also had a poorer prognosis (hazard ratio 4.35, 95% confidence interval 1.26-17.74, P = 0.020).MNA revealed that 75% of patients with ADHF had malnutrition or were at risk of malnutrition. The combination of low MNA and low TTR on admission can predict the prognosis of patients with ADHF. (Int Heart J 2015; 56: 226-233)

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Characteristics and Outcomes of Hospitalized Patients With Heart Failure and Reduced vs Preserved Ejection Fraction

Cited by 53 publications

References 0 publications

Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

Incidence and Predictors of Rehospitalization of Acute Heart Failure Patients

Arterial Stiffness Is Significantly Associated With Left Ventricular Diastolic Dysfunction in Patients With Cardiovascular Disease

Assessment of Transthyretin Combined With Mini Nutritional Assessment on Admission Provides Useful Prognostic Information in Patients With Acute Decompensated Heart Failure

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