Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study
OBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participant...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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BMJ Publishing Group
2014
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| _version_ | 1797058874322190336 |
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| author | Taylor, C Roalfe, A Tait, L Davis, R Iles, R Derit, M Hobbs, F |
| author_facet | Taylor, C Roalfe, A Tait, L Davis, R Iles, R Derit, M Hobbs, F |
| author_sort | Taylor, C |
| collection | OXFORD |
| description | OBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participants from the original Echocardiographic Heart of England Screening (ECHOES) study were invited to attend for rescreening. OUTCOME MEASURES: Prevalence of heart failure at rescreening overall and for each original ECHOES subgroup. Test performance of N Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels at different thresholds for screening. RESULTS: 1618 of 3408 participants underwent screening which represented 47% of survivors and 26% of the original ECHOES cohort. A total of 176 (11%, 95% CI 9.4% to 12.5%) participants were classified as having heart failure at rescreening; 103 had heart failure with reduced ejection fraction (HFREF) and 73 had heart failure with preserved ejection fraction (HFPEF). Sixty-eight out of 1232 (5.5%, 95% CI 4.3% to 6.9%) participants who were recruited from the general population over the age of 45 and did not have heart failure in the original study, had heart failure on rescreening. An NT-proBNP cut-off of 400 pg/mL had sensitivity for a diagnosis of heart failure of 79.5% (95% CI 72.4% to 85.5%) and specificity of 87% (95% CI 85.1% to 88.8%). CONCLUSIONS: Rescreening identified new cases of HFREF and HFPEF. Progression to heart failure poses a significant threat over time. The natriuretic peptide cut-off level for ruling out heart failure must be low enough to ensure cases are not missed at screening. |
| first_indexed | 2024-03-06T19:56:31Z |
| format | Journal article |
| id | oxford-uuid:25cbcf6b-d00f-49e7-9b6f-d07e2be3c6b3 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:56:31Z |
| publishDate | 2014 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:25cbcf6b-d00f-49e7-9b6f-d07e2be3c6b32022-03-26T11:57:34ZObservational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:25cbcf6b-d00f-49e7-9b6f-d07e2be3c6b3EnglishSymplectic Elements at OxfordBMJ Publishing Group2014Taylor, CRoalfe, ATait, LDavis, RIles, RDerit, MHobbs, FOBJECTIVES: Rescreen a large community cohort to examine the progression to heart failure over time and the role of natriuretic peptide testing in screening. DESIGN: Observational longitudinal cohort study. SETTING: 16 socioeconomically diverse practices in central England. PARTICIPANTS: Participants from the original Echocardiographic Heart of England Screening (ECHOES) study were invited to attend for rescreening. OUTCOME MEASURES: Prevalence of heart failure at rescreening overall and for each original ECHOES subgroup. Test performance of N Terminal pro-B-type Natriuretic Peptide (NT-proBNP) levels at different thresholds for screening. RESULTS: 1618 of 3408 participants underwent screening which represented 47% of survivors and 26% of the original ECHOES cohort. A total of 176 (11%, 95% CI 9.4% to 12.5%) participants were classified as having heart failure at rescreening; 103 had heart failure with reduced ejection fraction (HFREF) and 73 had heart failure with preserved ejection fraction (HFPEF). Sixty-eight out of 1232 (5.5%, 95% CI 4.3% to 6.9%) participants who were recruited from the general population over the age of 45 and did not have heart failure in the original study, had heart failure on rescreening. An NT-proBNP cut-off of 400 pg/mL had sensitivity for a diagnosis of heart failure of 79.5% (95% CI 72.4% to 85.5%) and specificity of 87% (95% CI 85.1% to 88.8%). CONCLUSIONS: Rescreening identified new cases of HFREF and HFPEF. Progression to heart failure poses a significant threat over time. The natriuretic peptide cut-off level for ruling out heart failure must be low enough to ensure cases are not missed at screening. |
| spellingShingle | Taylor, C Roalfe, A Tait, L Davis, R Iles, R Derit, M Hobbs, F Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title | Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title_full | Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title_fullStr | Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title_full_unstemmed | Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title_short | Observational longitudinal cohort study to determine progression to heart failure in a screened community population: the Echocardiographic Heart of England Screening Extension (ECHOES-X) study |
| title_sort | observational longitudinal cohort study to determine progression to heart failure in a screened community population the echocardiographic heart of england screening extension echoes x study |
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