Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis
Abstract Aims Heart failure (HF) is a common complication and the leading cause of mortality in maintenance haemodialysis (MHD) patients. Few studies have investigated heart failure with preserved ejection fraction (HFpEF), which is known to affect a majority of patients. The objective of this study...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.14447 |
| _version_ | 1797661440604110848 |
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| author | Xixi Yu Di Zhang Jing Chen Han Zhang Ziyan Shen Shiqi Lv Yulin Wang Xinhui Huang Xiaoyan Zhang Chun Zhang |
| author_facet | Xixi Yu Di Zhang Jing Chen Han Zhang Ziyan Shen Shiqi Lv Yulin Wang Xinhui Huang Xiaoyan Zhang Chun Zhang |
| author_sort | Xixi Yu |
| collection | DOAJ |
| description | Abstract Aims Heart failure (HF) is a common complication and the leading cause of mortality in maintenance haemodialysis (MHD) patients. Few studies have investigated heart failure with preserved ejection fraction (HFpEF), which is known to affect a majority of patients. The objective of this study is to explore the prevalence, clinical profiles, diagnosis, risk factors and prognosis of MHD patients with HFpEF. Methods and results Four hundred thirty‐nine patients haemodialyzsed for over 3 months were enrolled in the study and evaluated for HF according to the European Society of Cardiology guidelines. Clinical and laboratory parameters were recorded at baseline. The median follow‐up of the study was 22.5 months. A total of 111 (25.3%) MHD patients were diagnosed with HF, while 94 (84.7%) of the HF patients were classified into HFpEF. The cut‐off value of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) was 4922.5 pg/mL for predicting HFpEF (sensitivity 0.840, specificity 0.723, AUC 0.866) in MHD patients. Age, diabetes mellitus, coronary artery disease and serum phosphorus were independent risk factors for the incidence of HFpEF in MHD patients while normal urine volume, haemoglobin, serum iron and serum sodium were protective factors. MHD patients with HFpEF had a higher risk of all‐cause mortality than those without HF (hazard ratio 2.47, 95% confidence interval 1.55–3.91, P < 0.0001). Conclusions The majority of MHD patients with HF were categorized into HFpEF, with a poor long‐term survival rate. NT‐proBNP beyond 4922.5 pg/mL performed well in the prediction of HFpEF in MHD patients. |
| first_indexed | 2024-03-11T18:45:30Z |
| format | Article |
| id | doaj.art-3a9820c6c5234bf3b68a9cd161517606 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-11T18:45:30Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-3a9820c6c5234bf3b68a9cd1615176062023-10-12T02:48:44ZengWileyESC Heart Failure2055-58222023-10-011052816282510.1002/ehf2.14447Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosisXixi Yu0Di Zhang1Jing Chen2Han Zhang3Ziyan Shen4Shiqi Lv5Yulin Wang6Xinhui Huang7Xiaoyan Zhang8Chun Zhang9Department of Nephrology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaKidney and Dialysis Institute of Shanghai Shanghai ChinaDepartment of Nephrology Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Nephrology Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Nephrology Zhongshan Hospital, Fudan University Shanghai ChinaKidney and Dialysis Institute of Shanghai Shanghai ChinaKidney and Dialysis Institute of Shanghai Shanghai ChinaKidney and Dialysis Institute of Shanghai Shanghai ChinaDepartment of Nephrology Zhongshan Hospital, Fudan University Shanghai ChinaDepartment of Nephrology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan ChinaAbstract Aims Heart failure (HF) is a common complication and the leading cause of mortality in maintenance haemodialysis (MHD) patients. Few studies have investigated heart failure with preserved ejection fraction (HFpEF), which is known to affect a majority of patients. The objective of this study is to explore the prevalence, clinical profiles, diagnosis, risk factors and prognosis of MHD patients with HFpEF. Methods and results Four hundred thirty‐nine patients haemodialyzsed for over 3 months were enrolled in the study and evaluated for HF according to the European Society of Cardiology guidelines. Clinical and laboratory parameters were recorded at baseline. The median follow‐up of the study was 22.5 months. A total of 111 (25.3%) MHD patients were diagnosed with HF, while 94 (84.7%) of the HF patients were classified into HFpEF. The cut‐off value of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) was 4922.5 pg/mL for predicting HFpEF (sensitivity 0.840, specificity 0.723, AUC 0.866) in MHD patients. Age, diabetes mellitus, coronary artery disease and serum phosphorus were independent risk factors for the incidence of HFpEF in MHD patients while normal urine volume, haemoglobin, serum iron and serum sodium were protective factors. MHD patients with HFpEF had a higher risk of all‐cause mortality than those without HF (hazard ratio 2.47, 95% confidence interval 1.55–3.91, P < 0.0001). Conclusions The majority of MHD patients with HF were categorized into HFpEF, with a poor long‐term survival rate. NT‐proBNP beyond 4922.5 pg/mL performed well in the prediction of HFpEF in MHD patients.https://doi.org/10.1002/ehf2.14447Heart failureNT‐proBNPMaintenance haemodialysisMortality |
| spellingShingle | Xixi Yu Di Zhang Jing Chen Han Zhang Ziyan Shen Shiqi Lv Yulin Wang Xinhui Huang Xiaoyan Zhang Chun Zhang Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis ESC Heart Failure Heart failure NT‐proBNP Maintenance haemodialysis Mortality |
| title | Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis |
| title_full | Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis |
| title_fullStr | Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis |
| title_full_unstemmed | Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis |
| title_short | Heart failure with preserved ejection fraction in haemodialysis patients: prevalence, diagnosis, risk factors, prognosis |
| title_sort | heart failure with preserved ejection fraction in haemodialysis patients prevalence diagnosis risk factors prognosis |
| topic | Heart failure NT‐proBNP Maintenance haemodialysis Mortality |
| url | https://doi.org/10.1002/ehf2.14447 |
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