Patients with HFpEF and HFmrEF have different clinical characteristics in Turkey: A multicenter observational study

Özlek, Bülent; Özlek, Eda; Ağuş, Hicaz Zencirkıran; Tekinalp, Mehmet; Kahraman, Serkan; Çil, Cem; Çeli̇k, Oğuzhan; Başaran, Özcan; Doğan, Volkan; Kaya, Bedri Caner; Rencüzoğulları, İbrahim; Ösken, Altuğ; Bekar, Lütfü; Çakır, Mustafa; Çelik, Yunus; Mert, Kadir Uğur; Sancar, Kadriye Memiç; Sevinç, Samet; Mert, Gurbet Özge; Biteker, Murat

doi:10.1016/j.ejim.2018.11.001

Cited by 16 publications

(19 citation statements)

References 28 publications

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“…The study was approved by the internal review board of the medical institution of Mugla Sitki Kocman University as a subgroup analysis of a larger study of patients aged ≥ 18 years at the time of enrollment with HFmrEF and HFpEF. Design and results of the original study have been described in detail elsewhere . In brief, the APOLLON registry population comprised consecutive outpatients with HFmrEF and HFpEF, presenting to cardiologists in participating Turkish cities (ClinicalTrials.gov identifier NCT03026114).…”

Section: Methodsmentioning

confidence: 99%

“…Design and results of the original study have been described in detail elsewhere. 8,9 In brief, the APOLLON registry population comprised consecutive outpatients with HFmrEF and HFpEF, presenting to cardiologists in participating Turkish cities (ClinicalTrials.gov identifier NCT03026114). This cross-sectional and observational study was conducted in 11 cities in seven regions of Turkey, which were differ in terms of demographic characteristics, ethnicity, educational levels, employment rates, level of welfare and economic structure.…”

Section: Methodsmentioning

confidence: 99%

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Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Özlek

Tekinalp

et al. 2019

Int J Clin Pract

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Summary Objectives To compare real‐world characteristics and management of individuals aged 80 and older with heart failure (HF) and mid‐range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) derived from a large cohort of survey and to compare them with those younger than 80 from the same survey. Methods This is an observational, multicentre and cross‐sectional study conducted in Turkey (NCT03026114). Consecutive 1065 (mean age of 67.1 ± 10.6 years) patients admitted to the cardiology outpatient units with HFmrEF and HFpEF were included. Results Participants aged 80 and older (n = 123, 11.5%) were more likely to be female (66.7% vs 52.5%, P = 0.003), had a higher prevalence of atrial fibrillation (49.6% vs 34%, P = 0.001), and anaemia (46.3% vs 33.4%, P = 0.005) than those who were younger than 80. N‐terminal pro B‐type natriuretic peptide levels were higher in those aged 80 and older than in those younger than 80 (1037 vs 550 pg/ml, P < 0.001). The prescription rates of HF medications (including in ACE‐Is/ARBs, β‐blockers, MRAs, digoxin, ivabradine and diuretics) were similar (P > 0.05) in both groups. Octogenarians did not significantly differ from younger patients in the prevalence of HFmrEF (24.4% vs 22.9%) and HFpEF (75.6% vs 77.1%). Coronary artery disease was associated with HFmrEF (P < 0.05), whereas atrial fibrillation was associated with HFpEF (P < 0.05) in octogenarians. Conclusions This study revealed that nearly 12% of the individuals with HFmrEF and HFpEF in this real‐world sample were aged 80 and older. Participants aged 80 and older are more likely to be female and have more comorbidities than those who were younger than 80. However, HF medication profiles were similar in both groups. This study also showed that associated factors with HFmrEF and HFpEF were differ in octogenarians.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Özlek

Tekinalp

et al. 2019

Int J Clin Pract

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“…Several possible explanations have been proposed. First, patients with HFmrEF frequently suffer from multiple comorbidities, including hypertension, diabetes, obesity, coronary artery disease, and metabolic syndrome [13,19,37]. On account of these coexisting conditions, clinical trials have emphasized that an increase in WHR was a major contributor to a systemic proinflammatory state, which is involved in myocardial fibrosis, hypertrophy, and pathological remodeling, ultimately promoting left ventricular dysfunction [13,38].…”

Section: Discussionmentioning

confidence: 99%

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Gao

Wan

et al. 2020

Obes Facts

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Background: Waist-to-hip ratio (WHR) is a strong predictor of mortality in patients with heart failure (HF). However, common WHR trajectories are not well established in HF with mid-range ejection fraction (HFmrEF) persons, and their relationship to clinical outcomes remains uncertain. Method: We prospectively enrolled 1,396 participants with HFmrEF (left ventricular ejection fraction 40-49%) from April 2013 through April 2017. The waist and hip circumferences of the subjects were measured at regular intervals, and the WHR was calculated as waist circumference divided by hip circumference. Latent mixture modeling was performed to identify WHR trajectories. We then used Cox proportional-hazard models to examine the association between WHR trajectory patterns and incident HF, incident cardiovascular disease (CVD), and all-cause mortality. Results: We identified four distinct WHR trajectory patterns: leanmoderate increase (9.2%), medium-stable/increase (32.7%), heavy-stable/increase (48.0%), and heavy-moderate decrease (10.1%). After multivariable adjustment, the heavy-stable/increase and heavy-moderate decrease patterns were associated with an increased all-cause mortality risk (heavy-stable/increase: adjusted hazard ratio [HR] 3.18, 95% confidence interval [CI] 2.75-4.62; heavy-moderate decrease: adjusted HR 2.32, 95% CI 1.71-3.04), incident CVD risk (heavy-stable/increase: adjusted HR 4.03, 95% CI 2.39-4.91; heavy-moderate decrease:

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“…We have recently performed larger, multicenter, observational study including 1065 patients with HFpEF or HFm-rEF, and compared all clinical or laboratory data [2]. The results of our study showed that, HFmrEF patients were more likely to be men, were more frequent smokers and alcohol users, were more likely to have ECG abnormalities, IHD, chronic kidney disease and history of hospitalization for heart failure (HF).…”

mentioning

confidence: 99%

“…We also comprehensively analyzed all echocardiographic data [2]. Compared to patients with HFpEF, those with HFm-rEF had larger left ventricle (LV) end-diastolic and end-systolic dimensions, higher left atrial volume index and LV mass index.…”

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confidence: 99%

Patients with HFpEF and HFmrEF have different clinical characteristics in Turkey: A multicenter observational study

Cited by 16 publications

References 28 publications

Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Clinical features of heart failure with mid‐range and preserved ejection fraction in octogenarians: Results of a multicentre, observational study

Trajectories of Waist-to-Hip Ratio and Adverse Outcomes in Heart Failure with Mid-Range Ejection Fraction

Does heart failure with mid-range ejection fraction resemble heart failure with preserved ejection fraction?

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