Diastolic index as a short-term prognostic factor in heart failure with preserved ejection fraction. Issue 2 (17th December 2020)

• Record Type: Journal Article
• Authors: Hoshida, Shiro; Hikoso, Shungo; Shinoda, Yukinori; Tachibana, Koichi; Minamisaka, Tomoko; Tamaki, Shunsuke; Yano, Masamichi; Hayashi, Takaharu; Nakagawa, Akito; Nakagawa, Yusuke; Yamada, Takahisa; Yasumura, Yoshio; Nakatani, Daisaku; Sakata, Yasushi
• Other Names: author non-byline.; Sakata Yasushi author non-byline.; Hikoso Shungo author non-byline.; Nakatani Daisaku author non-byline.; Mizuno Hiroya author non-byline.; Suna Shinichiro author non-byline.; Okada Katsuki author non-byline.; Dohi Tomoharu author non-byline.; Sotomi Yohei author non-byline.; Kojima Takayuki author non-byline.; Sunaga Akihiro author non-byline.; Kida Hirota author non-byline.; Oeun Bolrathanak author non-byline.; Sato Taiki author non-byline.; Tamaki Shunsuke author non-byline.; Watanabe Tetsuya author non-byline.; Yamada Takahisa author non-byline.; Hayashi Takaharu author non-byline.; Higuchi Yoshiharu author non-byline.; Masuda Masaharu author non-byline.; Asai Mitsutoshi author non-byline.; Mano Toshiaki author non-byline.; Fuji Hisakazu author non-byline.; Masuda Daisaku author non-byline.; Takeda Yoshihiro author non-byline.; Nagai Yoshiyuki author non-byline.; Yamashita Shizuya author non-byline.; Sairyo Masami author non-byline.; Nakagawa Yusuke author non-byline.; Nozaki Shuichi author non-byline.; Abe Haruhiko author non-byline.; Ueda Yasunori author non-byline.; Uematsu Masaaki author non-byline.; Koretsune Yukihiro author non-byline.; Nagai Kunihiko author non-byline.; Yano Masamichi author non-byline.; Nishino Masami author non-byline.; Tanouchi Jun author non-byline.; Arita Yoh author non-byline.; Hasegawa Shinji author non-byline.; Ishizu Takamaru author non-byline.; Ichikawa Minoru author non-byline.; Takano Yuzuru author non-byline.; Rin Eisai author non-byline.; Shinoda Yukinori author non-byline.; Hoshida Shiro author non-byline.; Izumi Masahiro author non-byline.; Yamamoto Hiroyoshi author non-byline.; Kato Hiroyasu author non-byline.; Nakatani Kazuhiro author non-byline.; Yasuga Yuji author non-byline.; Nishio Mayu author non-byline.; Hirooka Keiji author non-byline.; Yoshimura Takahiro author non-byline.; Yasuoka Yoshinori author non-byline.; Tani Akihiro author non-byline.; Okumoto Yasushi author non-byline.; Akagi Hideharu author non-byline.; Makino Yasunaka author non-byline.; Onishi Toshinari author non-byline.; Iwakura Katsuomi author non-byline.; Nishikawa Nagahiro author non-byline.; Kijima Yoshiyuki author non-byline.; Kitao Takashi author non-byline.; Kanai Hideyuki author non-byline.; Shioyama Wataru author non-byline.; Fujita Masashi author non-byline.; Harada Koichiro author non-byline.; Kumada Masahiro author non-byline.; Nakagawa Osamu author non-byline.; Araki Ryo author non-byline.; Yamada Takayuki author non-byline.; Nakagawa Akito author non-byline.; Yasumura Yoshio author non-byline.; Sato Taiki author non-byline.; Sunaga Akihiro author non-byline.; Oeun Bolrathanak author non-byline.; Kida Hirota author non-byline.; Kojima Takayuki author non-byline.; Sotomi Yohei author non-byline.; Dohi Tomoharu author non-byline.; Nakamoto Kei author non-byline.; Okada Katsuki author non-byline.; Sera Fusako author non-byline.; Suna Shinichiro author non-byline.; Kioka Hidetaka author non-byline.; Ohtani Tomohito author non-byline.; Takeda Toshihiro author non-byline.; Nakatani Daisaku author non-byline.; Mizuno Hiroya author non-byline.; Hikoso Shungo author non-byline.; Matsumura Yasushi author non-byline.; Sakata Yasushi author non-byline.;
• Is Part Of: Open heart. Volume 7:Issue 2(2020)
• Publication Date: 2020-12-17
• Subjects: echocardiography -- heart failure -- diastolic -- biomarkers; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Patients -- Periodicals; 616.12005
• DOI: 10.1136/openhrt-2020-001469
• Languages: English
• ISSNs: 2398-595X

Abstract

Abstract : Objective: During follow-up time, the value of prognostic factors may change, especially in the elderly patients, and the altered extent may affect the prognosis. We aimed to clarify the significance of the ratio of diastolic elastance (Ed) to arterial elastance (Ea), (Ed/Ea=(E/e')/(0.9×systolic blood pressure)), an afterload-integrated diastolic index, in relation to follow-up periods and other laboratory factors, on the prognosis of elderly patients with heart failure with preserved ejection fraction (HFpEF). Methods: We studied 552 HFpEF patients hospitalised for acute decompensated heart failure (men/women: 255/297). Blood testing and transthoracic echocardiography were performed before discharge. The primary endpoint was all-cause mortality. Results: During a median follow-up of 508 days, 88 patients (men/women: 39/49) had all-cause mortality. During the first year after discharge, Ed/Ea (p=0.045) was an independent prognostic factor in association with albumin (p<0.001) and N-terminal pro-brain natriuretic peptide (NT-proBNP, p=0.005) levels after adjusting for age and sex in the multivariate Cox hazard analysis. However, at 1 to 3 years after discharge, no other significant prognostic factors, except for albumin level (p=0.046), were detected. In the subgroup analysis, albumin, but not NT-proBNP level, showed a significant interaction with Ed/Ea for prognosis (p=0.047). Conclusion: The prognostic significance of a haemodynamic parameter such as Ed/Ea may be valid only during a short-term period, but that of albumin was persisting during the entire follow-up period in the elderly patients. The clinical significance of prognostic factors in HFpEF patients may differ according to the follow-up period.