Document Detail


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:  MEDLINE    
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 structure and function. This has sparked debate as to whether HFpEF represents a distinct disease or an amalgamation of comorbidities. We hypothesized that fundamental cardiovascular structural and functional alterations are characteristic of HFpEF, even after accounting for body size and comorbidities.
METHODS AND RESULTS: Comorbidity-adjusted cardiovascular 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/sex-matched healthy n=193 and hypertensive, n=386 controls. Within HFpEF patients, body size and concomitant comorbidity-adjusted cardiovascular structural and functional parameters and survival were compared in those with and without individual comorbidities. Among HFpEF patients, comorbidities (obesity, anemia, diabetes mellitus, and renal dysfunction) were each associated with unique clinical, structural, functional, and prognostic profiles. However, after accounting for age, sex, body size, and comorbidities, greater concentric hypertrophy, atrial enlargement and systolic, diastolic, and vascular dysfunction were consistently observed in HFpEF compared with age/sex-matched normotensive and hypertensive.
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; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-17
Journal Detail:
Title:  Circulation. Heart failure     Volume:  5     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  2013-04-01     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  710-9     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anemia / epidemiology
Case-Control Studies
Cohort Studies
Comorbidity
Diabetes Mellitus / epidemiology
Echocardiography, Doppler
Female
Heart Atria / pathology,  physiopathology,  ultrasonography
Heart Failure / epidemiology,  pathology*,  physiopathology*
Heart Ventricles / pathology*,  physiopathology*,  ultrasonography
Humans
Hypertrophy, Left Ventricular / pathology,  physiopathology,  ultrasonography
Kidney Diseases / epidemiology
Male
Obesity / epidemiology
Stroke Volume / physiology*
Grant Support
ID/Acronym/Agency:
HL 55502/HL/NHLBI NIH HHS; HL080076/HL/NHLBI NIH HHS; HL72435/HL/NHLBI NIH HHS; P01 HL076611/HL/NHLBI NIH HHS; P01HL 76611/HL/NHLBI NIH HHS; R01 HL055502/HL/NHLBI NIH HHS; R01 HL072435/HL/NHLBI NIH HHS; R01 HL080076/HL/NHLBI NIH HHS; T32 HL007111/HL/NHLBI NIH HHS; T32-HL0711/HL/NHLBI NIH HHS; U01 HL084907/HL/NHLBI NIH HHS; U01HL 84907/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Circ Heart Fail. 2012 Nov;5(6):669-71   [PMID:  23170020 ]

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