Imaging predictors of incident heart failure: a systematic review and meta-analysis

Georgiopoulos, Georgios; Aimo, Alberto; Barison, Andrea; Magkas, Nikolaos; Emdin, Michele; Masci, Pier Giorgio

doi:10.2459/jcm.0000000000001133

Cited by 9 publications

(15 citation statements)

References 54 publications

(222 reference statements)

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“…In a specular fashion, a transition from HF with preserved ejection fraction to HFmrEF or from HFmrEF to HFrEF predicted a higher risk of death and/or hospitalization, 48 and a decline in LVEF was found to precede death in a large cohort of HF outpatients 49 . LVEF decrease follows LV dilation and denotes the failure of LV dilation as a compensatory mechanism to sustain systolic LV function 50 . It is then reasonable to speculate that HF therapy may cause a decrease in LV volumes and then a recovery in LV function and that patients achieving a substantial increase in LVEF (such as a change in LVEF category or an increase by more than 10 units) have also a better long‐term outcome.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

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Aims Reverse remodelling (RR) is the recovery from left ventricular (LV) dilatation and dysfunction. Many arbitrary criteria for RR have been proposed. We searched the criteria with the strongest prognostic yield for the hard endpoint of cardiovascular death. Methods and resultsWe performed a systematic literature search of diagnostic criteria for RR. We evaluated their prognostic significance in a cohort of 927 patients with LV ejection fraction (LVEF) < 50% undergoing two echocardiograms within 12 ± 2 months. These patients were followed for a median of 2.8 years (interquartile interval 1.3-4.9) after the second echocardiogram, recording 123 cardiovascular deaths. Two prognostic models were defined. Model 1 included age, LVEF, N-terminal pro-B-type natriuretic peptide, ischaemic aetiology, cardiac resynchronization therapy, estimated glomerular filtration rate, New York Heart Association, and LV end-systolic volume (LVESV) index, and Model 2 the validated Cardiac and Comorbid Conditions Heart Failure score. We identified 25 criteria for RR, the most used being LVESV reduction ≥15% (12 studies out of 42). In the whole cohort, two criteria proved particularly effective in risk reclassification over Model 1 and Model 2. These criteria were (i) LVEF increase >10 U and (ii) LVEF increase ≥1 category [severe (LVEF ≤ 30%), moderate (LVEF 31-40%), mild LV dysfunction (LVEF 41-55%), and normal LV function (LVEF ≥ 56%)]. The same two criteria yielded independent prognostic significance and improved risk reclassification even in patients with more severe systolic dysfunction, namely, those with LVEF < 40% or LVEF ≤ 35%. Furthermore, LVEF increase >10 U and LVEF increase ≥1 category displayed a greater prognostic value than LVESV reduction ≥15%, both in the whole cohort and in the subgroups with LVEF < 40% or LVEF ≤ 35%. For example, LVEF increase >10 U independently predicted cardiovascular death over Model 1 and LVESV reduction ≥15% (hazard ratio 0.40, 95% confidence interval 0.18-0.90, P = 0.026), while LVESV reduction ≥15% did not independently predict cardiovascular death (P = 0.112). Conclusions Left ventricular ejection fraction increase >10 U and LVEF increase ≥1 category are stronger predictors of cardiovascular death than the most commonly used criterion for RR, namely, LVESV reduction ≥15%.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

et al. 2021

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“…Prior evaluations on the incidence of HF have focused on the development of symptomatic, clinical HF (Stages C and D). 13 , 40 , 41 However, with the rise in prevalence of HF there is increasing interest in HF primary prevention, with a focus on the preclinical HF stages (Stages A and B). Previous studies have shown that there is a high prevalence of preclinical HF and that these individuals have both an increased risk of developing clinical HF as well as increased mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Preclinical Heart Failure in a Community Population

Young

Scott

Rodeheffer

et al. 2022

JAHA

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Background A high prevalence of preclinical heart failure (HF) (Stages A and B) has previously been shown. The aim of this study was to explore factors associated with the incidence of preclinical HF in a community population. Methods and Results Retrospective review of 393 healthy community individuals aged ≥45 years from the Olmsted County Heart Function Study that returned for 2 visits, 4 years apart. At visit 2, individuals that remained normal were compared with those that developed preclinical HF. By the second visit, 191 (49%) developed preclinical HF (12.1 cases per 100 person‐years of follow‐up); 65 (34%) Stage A and 126 (66%) Stage B. Those that developed preclinical HF (n=191) were older ( P =0.004), had a higher body mass index ( P <0.001), and increased left ventricular mass index ( P =0.006). When evaluated separately, increased body mass index was seen with development of Stage A ( P <0.001) or Stage B ( P =0.009). Echocardiographic markers of diastolic function were statistically different in those that developed Stage A [higher E/e’ ( P <0.001), lower e’ ( P <0.001)] and Stage B [higher left atrial volume index ( P <0.001), higher E/e’ ( P <0.001), lower e’ ( P <0.001)]. NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) was higher at visit 2 in those that developed Stage A or B ( P <0.001 for both). Hypertension (57%), obesity (34%), and hyperlipidemia (25%) were common in the development of Stage A. Of patients who developed Stage B, 71% (n=84) had moderate or severe diastolic dysfunction. Conclusions There is a high incidence of preclinical HF in a community population. Development of Stage A was driven by hypertension and obesity, while preclinical diastolic dysfunction was seen commonly in those that developed Stage B.

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“…More specifically, cardiac systolic and diastolic function and the carotid artery's elasticity are affected in CCS with a higher burden of cancer treatment, and the latter correlates with apolipoprotein abnormalities. These ultrasonographical and lipid and apolipoprotein markers are known risk-factors for future CVD in different patient populations (25)(26)(27)(28)(29), but how they predict CVD in CCS remains elusive.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Cardiac, Vascular, and Metabolic Changes in Young Childhood Cancer Survivors

et al. 2021

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Background: Childhood cancer survivors (CCS) are at an increased risk for cardiovascular diseases (CVD). It was the primary aim of this study to determine different measures of cardiac, carotid, lipid, and apolipoprotein status in young adult CCS and in healthy controls.Methods: Cardiac and common carotid artery (CCA) structure and function were measured by ultrasonography. Lipids and apolipoproteins were measured in the blood. Peripheral arterial endothelial vasomotor function was assessed by measuring digital reactive hyperemia index (PAT-RHI) using the Endo-PAT 2000.Results: Fifty-three CCS (20–30 years, 35 men) and 53 sex-matched controls were studied. The CCS cohort was divided by the median dose of anthracyclines into a low anthracycline dose (LAD) group (50–197 mg/m2, n = 26) and a high anthracycline dose (HAD) group (200–486 mg/m2, n = 27). Carotid distensibility index (DI) and endothelial function determined by PAT-RHI were both lower in the CCS groups compared with controls (p < 0.05 and p = 0.02). There was no difference in carotid intima media thickness. Atherogenic apolipoprotein-B (Apo-B) and the ratio between Apo-B and Apoliprotein-A1 (Apo-A1) were higher in the HAD group compared with controls (p < 0.01). Apo-B/Apo-A1-ratio was over reference limit in 29.6% of the HAD group, in 15.4% of LAD group, and in 7.5% of controls (p = 0.03). Measured lipid markers (low density lipoprotein and total cholesterol and triglycerides) were higher in both CCS groups compared with controls (p < 0.05). Systolic and diastolic function were measurably decreased in the HAD group, as evidenced by lower EF (p < 0.001) and lower é-wave (p < 0.005) compared with controls. CCA DI correlated with Apo-B/Apo-A1-ratio and Apo-A1. Follow-up time after treatment correlated with decreased left ventricular ejection fraction (p = 0.001).Conclusion: Young asymptomatic CCS exhibit cardiac, vascular, lipid, and apolipoprotein changes that could account for increased risk for CVD later in life. These findings emphasize the importance of cardiometabolic monitoring even in young CCS.

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Imaging predictors of incident heart failure: a systematic review and meta-analysis

Cited by 9 publications

References 54 publications

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

Incidence of Preclinical Heart Failure in a Community Population

Characterization of Cardiac, Vascular, and Metabolic Changes in Young Childhood Cancer Survivors

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