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Comorbidity and Ventricular and Vascular Structure and Function in Heart Failure with Preserved Ejection Fraction: A Community Based Study.
MedLine Citation:
PMID:  23076838     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Patients with heart failure and preserved ejection fraction (HFpEF) display increased adiposity and multiple comorbidities, factors that in themselves may influence cardiovascular (CV) structure and function. This has sparked debate as to whether HFpEF represents a distinct disease or an amalgamation of comorbidities. We hypothesized that fundamental CV structural and functional alterations are characteristic of HFpEF, even after accounting for body size and comorbidities. METHODS AND RESULTS: -Comorbidity adjusted CV structural and functional parameters scaled to independently generated and age appropriate allometric powers were compared in community-based cohorts of HFpEF patients (n=386) and age/gender-matched healthy (CON, n=193) and hypertensive (HTN, n=386) controls. Within HFpEF patients, body size and concomitant comorbidity adjusted CV structural and functional parameters and survival were compared in those with and without individual comorbidities. Among HFpEF patients, comorbidities (obesity, anemia, diabetes and renal dysfunction) were each associated with unique clinical, structural, functional and prognostic profiles. However, after accounting for age, gender, body size and comorbidities, greater concentric hypertrophy, atrial enlargement and systolic, diastolic and vascular dysfunction were consistently observed in HFpEF compared to CON and HTN. CONCLUSIONS: -Comorbidities influence ventricular-vascular properties and outcomes in HFpEF, yet fundamental disease-specific changes in cardiovascular structure and function underlie this disorder. These data support the search for mechanistically-targeted therapies in this disease.
Authors:
Selma F Mohammed; Barry A Borlaug; Véronique L Roger; Sultan A Mirzoyev; Richard J Rodeheffer; Julio A Chirinos; Margaret M Redfield
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-17
Journal Detail:
Title:  Circulation. Heart failure     Volume:  -     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Mayo Clinic, Rochester, MN;
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