Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure
Abstract Aims The prognostic importance of admission systolic blood pressure (SBP) in heart failure with preserved ejection fraction (HFpEF) is elusive. We aimed to clarify the pathophysiological differences between patients categorized with admission SBP among HFpEF patients. Methods and results We...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13420 |
| _version_ | 1818606307984277504 |
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| author | Akito Nakagawa Yoshio Yasumura Chikako Yoshida Takahiro Okumura Jun Tateishi Junichi Yoshida Shunsuke Tamaki Masamichi Yano Takaharu Hayashi Yusuke Nakagawa Takahisa Yamada Daisaku Nakatani Shungo Hikoso Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators |
| author_facet | Akito Nakagawa Yoshio Yasumura Chikako Yoshida Takahiro Okumura Jun Tateishi Junichi Yoshida Shunsuke Tamaki Masamichi Yano Takaharu Hayashi Yusuke Nakagawa Takahisa Yamada Daisaku Nakatani Shungo Hikoso Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators |
| author_sort | Akito Nakagawa |
| collection | DOAJ |
| description | Abstract Aims The prognostic importance of admission systolic blood pressure (SBP) in heart failure with preserved ejection fraction (HFpEF) is elusive. We aimed to clarify the pathophysiological differences between patients categorized with admission SBP among HFpEF patients. Methods and results We studied 1008 inpatients from PURSUIT‐HFpEF, a multicentre prospective observational registry. We classified patients as having elevated (>140 mmHg), preserved (90–140 mmHg), or low (<90 mmHg) admission SBP. Most cases had elevated (n = 584) or preserved (n = 420) SBP; the four cases with low SBP were excluded. Univariable Cox regression testing revealed that preserved SBP patients had a higher risk of a composite of cardiac death and heart failure re‐hospitalization [hazard ratio (HR) 1.48, 95% confidence interval (CI) 1.14–1.92, P = 0.0035] than elevated SBP patients. In multivariable Cox regression models, while prior heart failure hospitalization (HR 1.36, 95% CI 1.01–2.84, P = 0.0453), atrial fibrillation (HR 1.82, 95% CI 1.10–2.99, P = 0.0209), and N‐terminal pro‐B‐type natriuretic peptide (HR 1.94, 95% CI 1.10–3.43, P = 0.0229) at discharge were significantly associated with adverse outcomes in elevated SBP patients, N‐terminal pro‐B‐type natriuretic peptide (HR 2.06, 95% CI 1.04–4.07, P = 0.0373) and right ventricular‐pulmonary artery uncoupling reflected by the tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio (HR 0.19, 95% CI 0.05–0.65, P = 0.0075) at discharge were significant prognostic factors in preserved SBP patients. Conclusions Patients with preserved admission SBP had significant higher risks for adverse outcomes than those with elevated SBP in HFpEF. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure was the distinctive prognostic factor between the two groups. |
| first_indexed | 2024-12-16T14:08:47Z |
| format | Article |
| id | doaj.art-49bc88797ffd4059a9902e7a5890bc57 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-16T14:08:47Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-49bc88797ffd4059a9902e7a5890bc572022-12-21T22:28:51ZengWileyESC Heart Failure2055-58222021-08-01843145315510.1002/ehf2.13420Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressureAkito Nakagawa0Yoshio Yasumura1Chikako Yoshida2Takahiro Okumura3Jun Tateishi4Junichi Yoshida5Shunsuke Tamaki6Masamichi Yano7Takaharu Hayashi8Yusuke Nakagawa9Takahisa Yamada10Daisaku Nakatani11Shungo Hikoso12Yasushi Sakata13Osaka CardioVascular Conference (OCVC)‐Heart Failure investigatorsDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiovascular Medicine Amagasaki‐Chuo Hospital 1‐12‐1 Shioe Amagasaki Hyogo 661‐0976 JapanDivision of Cardiology Osaka General Medical Center Osaka JapanDivision of Cardiology Osaka Rosai Hospital Osaka JapanDivision of Cardiology Osaka Police Hospital Osaka JapanDivision of Cardiology Kawanishi City Hospital Kawanishi JapanDivision of Cardiology Osaka General Medical Center Osaka JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanAbstract Aims The prognostic importance of admission systolic blood pressure (SBP) in heart failure with preserved ejection fraction (HFpEF) is elusive. We aimed to clarify the pathophysiological differences between patients categorized with admission SBP among HFpEF patients. Methods and results We studied 1008 inpatients from PURSUIT‐HFpEF, a multicentre prospective observational registry. We classified patients as having elevated (>140 mmHg), preserved (90–140 mmHg), or low (<90 mmHg) admission SBP. Most cases had elevated (n = 584) or preserved (n = 420) SBP; the four cases with low SBP were excluded. Univariable Cox regression testing revealed that preserved SBP patients had a higher risk of a composite of cardiac death and heart failure re‐hospitalization [hazard ratio (HR) 1.48, 95% confidence interval (CI) 1.14–1.92, P = 0.0035] than elevated SBP patients. In multivariable Cox regression models, while prior heart failure hospitalization (HR 1.36, 95% CI 1.01–2.84, P = 0.0453), atrial fibrillation (HR 1.82, 95% CI 1.10–2.99, P = 0.0209), and N‐terminal pro‐B‐type natriuretic peptide (HR 1.94, 95% CI 1.10–3.43, P = 0.0229) at discharge were significantly associated with adverse outcomes in elevated SBP patients, N‐terminal pro‐B‐type natriuretic peptide (HR 2.06, 95% CI 1.04–4.07, P = 0.0373) and right ventricular‐pulmonary artery uncoupling reflected by the tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio (HR 0.19, 95% CI 0.05–0.65, P = 0.0075) at discharge were significant prognostic factors in preserved SBP patients. Conclusions Patients with preserved admission SBP had significant higher risks for adverse outcomes than those with elevated SBP in HFpEF. Tricuspid annular plane systolic excursion/pulmonary artery systolic pressure was the distinctive prognostic factor between the two groups.https://doi.org/10.1002/ehf2.13420Heart failureBlood pressurePrognosis |
| spellingShingle | Akito Nakagawa Yoshio Yasumura Chikako Yoshida Takahiro Okumura Jun Tateishi Junichi Yoshida Shunsuke Tamaki Masamichi Yano Takaharu Hayashi Yusuke Nakagawa Takahisa Yamada Daisaku Nakatani Shungo Hikoso Yasushi Sakata Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure ESC Heart Failure Heart failure Blood pressure Prognosis |
| title | Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| title_full | Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| title_fullStr | Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| title_full_unstemmed | Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| title_short | Distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| title_sort | distinctive prognostic factor of heart failure with preserved ejection fraction stratified with admission blood pressure |
| topic | Heart failure Blood pressure Prognosis |
| url | https://doi.org/10.1002/ehf2.13420 |
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