Prognostic significance of dipstick proteinuria in heart failure with preserved ejection fraction: insight from the PURSUIT-HFpEF registry

Oeun, Bolrathanak; Hikoso, Shungo; Nakatani, Daisaku; Mizuno, Hiroya; Suna, Shinichiro; Kitamura, Tetsuhisa; Okada, Katsuki; Dohi, Tomoharu; Sotomi, Yohei; Kida, Hirota; Sunaga, Akihiro; Sato, Taiki; Nakagawa, Akito; Nakagawa, Yusuke; Hayashi, Toshimitsu; Yano, Masamichi; Tamaki, Shunsuke; Yasumura, Yoshio; Yamada, Takahisa; Sakata, Yasushi

doi:10.1136/bmjopen-2021-049371

Cited by 4 publications

(2 citation statements)

References 41 publications

(38 reference statements)

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“…Proteinuria and CKD are characterized as extracardiac clinical red flags, these conditions are already common in the HFpEF population. Although the prevalence of proteinuria and CKD varies depending on the age and comorbidities of the patient population included in the studies, it has been reported that 30%-41% of patients with HfpEF have proteinuria [26][27][28], and 26%-49% have CKD [29]. Similar to previous studies, in our study population, we observed proteinuria in 15 (17.6%) patients (8 with CKD, 7 without CKD) and CKD in 33 (38.8%) patients.…”

Section: Extracardiac and Cardiac Clinical Red Flagssupporting

confidence: 87%

Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

et al. 2022

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Background: Heart failure with preserved ejection fraction (HFpEF) is heterogeneous clinical syndrome. Transthyretin cardiac amyloidosis (CA) is an underdiagnosed cause of HFpEF. Red flags are extremely useful for suspecting CA. Aims:We aimed to evaluate the frequency of cardiac and extracardiac manifestations of CA in HFpEF patients based on red flags.Methods: Baseline characteristics of 85 patients were recorded during admission. Electrocardiogram and echocardiography were performed. All patients were examined for red flags. Cardiac scintigraphy was performed in 85 patients. Results:The mean (standard deviation [SD]) age of the study group was 67.9 (9.8) years, and 52 (61.2%) patients were female. At least 1 red flag was observed in 67% of HFpEF patients. Only 4 of the patients had more than 3 red flags. The mean number of red flags in a patient with HFpEF was 1.3. Extracardiac clinical red flags were observed in only 9 (10.5%) patients. Cardiac clinical red flags were extremely rare. An electrocardiographic red flag was detected in 2 out of 10 patients and an echocardiographic red flag in 4 out of 10 patients with HFpEF. Scintigraphy showed that 17.6% of all patients have had a grade 2 or 3 cardiac uptake. The patients with wild-type transthyretin CA had twice as many red flags as those without. Conclusion:The results of the study showed that patients diagnosed with HFpEF had an average of 1.3 red flags suggestive of CA. In real life, extracardiac red flags are rare, while electrocardiographic and echocardiographic red flags are more common in patients with HFpEF.

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Section: Extracardiac and Cardiac Clinical Red Flagssupporting

confidence: 87%

Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

et al. 2022

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“…In addition to kidney disease, proteinuria is considered a potent predictor for cardiovascular disease [1][2][3]. In the past two decades, the causes of proteinuria have been attributed to diabetes and hypertension [1,4], which have been increasing worldwide.…”

Section: Introductionmentioning

confidence: 99%

U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

Igata

Nakajima

2022

J Clin Med Res

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Background: Although a very high level of high-density lipoprotein cholesterol (HDL-C) may be a potential cardiovascular disease risk factor, the detail and underlying mechanism remain unclear. Therefore, we examined the associations of serum HDL-C with the incidence of proteinuria, a predictor for cardiovascular disease, in a community-based study. Methods:We investigated clinical parameters, including serum HDL-C and proteinuria, among 1,191,409 people aged 40 -74 years who underwent a health checkup in a cross-sectional study. In the cohort study, the incidence of proteinuria after 6 years was investigated in 451,987 participants without proteinuria at baseline, who were simultaneously enrolled in the cross-sectional study. Results:The prevalence of proteinuria showed a U-shaped relationship with 10 HDL-C categories, with a minimum of 60 -89 mg/dL in the cross-sectional study. Logistic regression analysis showed similar U-shaped relationships between odds ratios for proteinuria and HDL-C categories, with a minimum of 70 -79 mg/dL. The associations between very high HDL-C (≥ 90 mg/dL) and proteinuria were strengthened after adjustment for body mass index (BMI). In the cohort study, a crude L-shaped relationship was observed between the incidence of proteinuria and baseline HDL-C, which turned into U-shaped relationship after adjustment for baseline BMI and HDL-C after 6 years.Conclusions: Low and very high levels of HDL-C may be associated with the incidence of proteinuria, and BMI may be a potent contributing factor to the underlying mechanism.

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Clinical trajectories and outcomes of patients with heart failure with preserved ejection fraction with normal or indeterminate diastolic function

et al. 2022

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Prognostic significance of dipstick proteinuria in heart failure with preserved ejection fraction: insight from the PURSUIT-HFpEF registry

Cited by 4 publications

References 41 publications

Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

Assessment of clinical characteristics of cardiac amyloidosis as a potential underlying etiology in patients diagnosed with heart failure with preserved ejection fraction

U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

Clinical trajectories and outcomes of patients with heart failure with preserved ejection fraction with normal or indeterminate diastolic function

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