Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction

Owan, Theophilus; Hodge, David O.; Herges, Regina M.; Jacobsen, Steven J.; Roger, Véronique L.; Redfield, Margaret M.

doi:10.1056/nejmoa052256

Cited by 3,641 publications

(2,912 citation statements)

References 30 publications

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“…Hypertension and age are major risk factors for HFpEF 34, 35. Community‐based studies have highlighted the high incidence of HFpEF in the elderly and very elderly (≥80 years of age) 36, 37, 38, 39.…”

Section: Aging Phenotypementioning

confidence: 99%

“…Though abnormal relaxation is the first mechanical manifestation of myocardial ischemia,194, 195, 196 acute coronary artery syndromes seldom precipitate HFpEF decompensation or present as HFpEF 100, 197. The prevalence of CAD ranges from 35% to 53% in large HFpEF registries 34, 35, 198. The prevalence of CAD in HFpEF varies with the ethnic background of patients.…”

Section: Cad Phenotypementioning

confidence: 99%

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Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

102

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Section: Aging Phenotypementioning

confidence: 99%

Section: Cad Phenotypementioning

confidence: 99%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

102

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“…The epidemiological burden of heart failure (HF) has grown in the past decades 1. The prevalence of HF with preserved ejection fraction (HFpEF) is high and increasing, making HFpEF a continuously growing public health problem 1, 2.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HF with preserved ejection fraction (HFpEF) is high and increasing, making HFpEF a continuously growing public health problem 1, 2. Morbidity and mortality in HFpEF are quite similar to HF with reduced ejection fraction (HFrEF), but no effective pharmacological treatment has been identified so far3, 4, 5, 6 and a successful management of the disease remains elusive 2.…”

Section: Introductionmentioning

confidence: 99%

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

et al. 2017

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AimsHeart failure with preserved ejection fraction (HFpEF) remains a common condition with no pharmacological treatment. Physical activity (PA) improves symptoms and quality of life (QoL), but no clear recommendations exist on PA in HFpEF patients. We investigated the association of PA (amount/intensity) on clinical phenotype in HFpEF.Methods and resultsThe Aldosterone in Diastolic Heart Failure trial investigated spironolactone vs. placebo in stable HFpEF patients. At baseline, all patients underwent detailed phenotypization including echocardiography, cardiopulmonary exercise testing, 6 minute walking test (6MWT), and QoL assessment (36‐item Short‐Form questionnaire). PA was assessed by a self‐report questionnaire, classified in metabolic equivalents of task (MET) and analysed with regard to exercise capacity, diastolic function, and QoL. Four hundred twenty‐two patients (52% women, age 67 ± 8 years, New York Heart Association II and III) were classified by weekly MET hours into a low (<70), middle (70–140), or high (>140) level of PA. Total PA correlated positively with 6MWT distance (r = 0.17; P = 0.002) and physical function of QoL (r = 0.10; P = 0.05), but not with peak oxygen uptake (peakVO2). In contrast, both 6MWT distance and peakVO2 were significantly higher in patients who performed high‐intensity PA for >8 h/week (P < 0.001, P = 0.02, respectively). Time of high‐intensity PA was related to higher 6MWT distance (r = 0.21, P < 0.001), peakVO2, and better physical function of QoL (both r = 0.13, P = 0.01), whereas low‐intensity PA did not show significant associations. Interestingly, PA was not related to any measure of diastolic function.ConclusionsA higher amount of PA is related to higher submaximal exercise capacity and physical function of QoL. Regarding maximal exercise capacity, only high‐intensity PA showed significant association in HFpEF patients.

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“…Diastolic HF, also referred to as HF with preserved ejection fraction, accounts for 50% of cases 2. Mortality of diastolic HF is 30% within 1 year of the first hospital admission 3. Subclinical diastolic left ventricular (LV) dysfunction has a prevalence of 25% in the general population,4, 5 predisposes to further deterioration of LV function,6 and finally evolves to overt HF 2.…”

mentioning

confidence: 99%

Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Wei

Yang

Thijs

et al. 2018

JAHA

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BackgroundNo longitudinal study compared associations of echocardiographic indexes of diastolic left ventricular function studies with conventional (CBP) and daytime ambulatory (ABP) blood pressure in the general population.Methods and ResultsIn 780 Flemish (mean age, 50.2 years; 51.7% women), we measured left atrial volume index (LAVI), peak velocities of the transmitral blood flow (E) and mitral annular movement (e′) in early diastole and E/e′ 9.6 years (median) after CBP and ABP. In adjusted models including CBP and ABP, we expressed associations per 10/5‐mm Hg systolic/diastolic blood pressure increments. LAVI and E/e′ were 0.65/0.40 mL/m2 and 0.17/0.09 greater with higher systolic/diastolic ABP (P≤0.028), but not with higher baseline CBP (P≥0.086). e′ was lower (P≤0.032) with higher diastolic CBP (−0.09 cm/s) and ABP (−0.19 cm/s). When we substituted baseline CBP by CBP recorded concurrently with echocardiography, LAVI and E/e′ remained 0.45/0.38 mL/m2 and 0.15/0.08 greater with baseline ABP (P≤0.036), while LAVI (+0.53 mL/m2) and E/e′ (+0.19) were also greater (P<0.001) in relation to concurrent systolic CBP. In categorized analyses of baseline data, sustained hypertension or masked hypertension compared with normotension or white‐coat hypertension was associated with greater LAVI (24.0 versus 22.6 mL/m2) and E/e′ (7.35 versus 6.91) and lower e′ (10.7 versus 11.6 cm/s; P≤0.006 for all) with no differences (P≥0.092) between normotension and white‐coat hypertension or between masked hypertension and sustained hypertension.Conclusions ABP is a long‐term predictor of diastolic left ventricular function, statistically outperforming distant but not concurrent CBP. Masked hypertension and sustained hypertension carry equal risk for deterioration of diastolic left ventricular function.

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Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction

Abstract: The prevalence of heart failure with preserved ejection fraction increased over a 15-year period, while the rate of death from this disorder remained unchanged. These trends underscore the importance of this growing public health problem.

Cited by 3,641 publications

References 30 publications

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction

Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

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