scholarly journals A prediction model for sudden cardiac death in patients with heart failure and preserved ejection fraction

2014 ◽  
Vol 16 (11) ◽  
pp. 1175-1182 ◽  
Author(s):  
Selcuk Adabag ◽  
Thomas S. Rector ◽  
Inder S. Anand ◽  
John J. McMurray ◽  
Michael Zile ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Prediction Model ◽  
Cardiac Death ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals Osteopontin and LDLR Are Upregulated in Hearts of Sudden Cardiac Death Victims With Heart Failure With Preserved Ejection Fraction and Diabetes Mellitus

2020 ◽  
Vol 7 ◽  
Author(s):  
Mausam Patel ◽  
Daniela Rodriguez ◽  
Keyvan Yousefi ◽  
Krista John-Williams ◽  
Armando J. Mendez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Cardiac Death ◽  
Density Lipoprotein ◽  
Molecular Pathways ◽  
Preserved Ejection Fraction ◽  
Control Subjects ◽  
Increased Risk

Background: Diabetes mellitus (DM) is associated with increased risk of sudden cardiac death (SCD), particularly in patients with heart failure with preserved ejection fraction (HFpEF). However, there are no known biomarkers in the population with DM and HFpEF to predict SCD risk.Objectives: This study was designed to test the hypothesis that osteopontin (OPN) and some proteins previously correlated with OPN, low-density lipoprotein receptor (LDLR), dynamin 2 (DNM2), fibronectin-1 (FN1), and 2-oxoglutarate dehydrogenase-like (OGDHL), are potential risk markers for SCD, and may reflect modifiable molecular pathways in patients with DM and HFpEF.Methods: Heart tissues were obtained at autopsy from 9 SCD victims with DM and HFpEF and 10 age and gender-matched accidental death control subjects from a Finnish SCD registry and analyzed for the expression of OPN and correlated proteins, including LDLR, DNM2, FN1, and OGDHL by immunohistochemistry.Results: We observed a significant upregulation in the expression of OPN, LDLR, and FN1, and a marked downregulation of DNM2 in heart tissues of SCD victims with DM and HFpEF as compared to control subjects (p < 0.01).Conclusions: The dysregulated protein expression of OPN, LDLR, FN1, and DNM2 in patients with DM and HFpEF who experienced SCD provides novel potential modifiable molecular pathways that may be implicated in the pathogenesis of SCD in these patients. Since secreted OPN and soluble LDLR can be measured in plasma, these results support the value of further prospective studies to assess the predictive value of these plasma biomarkers and to determine whether tuning expression levels of OPN and LDLR alters SCD risk in patients with DM and HFpEF.

P6257Low systolic blood pressure on admission as a predictor of outcome in octogenarian patients with heart failure and preserved ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Tsuda ◽  
Y Kanzaki ◽  
D Maeda ◽  
K Akamatsu ◽  
S Nakayama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
Cardiac Death ◽  
Preserved Ejection Fraction ◽  
Very Elderly ◽  
Patients With Heart Failure ◽  
Poor Outcomes

Abstract Background Heart failure (HF) is an epidemic in healthcare worldwide including Asia. It appears that HF will become more serious with aging of the population. The patients with heart failure and preserved ejection fraction (HFpEF) were older, more often female, and frequently have comorbidities including hypertension. However, lower systolic blood pressure (SBP) on admission is associated with poor outcomes in patients with HF. It remains unclear whether this association is similar in very elderly patients with HFpEF. Purpose To investigate clinical features and prognosis in octogenarian HFpEF subjects. Methods We analyzed 87 consecutive subjects aged 80 years or older who were hospitalized for acute decompensated HF with left ventricular ejection fraction (LVEF) ≥50% between 2015 and 2017. Clinical characteristics and a composite event of cardiac death and HF hospitalization were compared in two groups according to SBP cut-off of 140 mmHg on admission. Results The prevalence of lower SBP subjects (mean BP = 118 mmHg) and higher SBP (mean BP = 166 mmHg) subjects were 41.4% and 58.6%, respectively. Lower SBP subjects were more comorbid with atrial fibrillation (72.2 vs. 45.1%, p=0.01). In the lower SBP group, diuretics, mineralocorticoid receptor antagonists (MRA), beta-blockers and ACE inhibitors/ARBs were more commonly used than higher SBP group (Table). During the observational period (median = 1.0 year), lower SBP on admission was associated with a 2.65-fold [95% confidence interval (CI): 1.29–5.55, p=0.009] greater likelihood of experiencing the composite events of cardiac death and rehospitalization for HF (Figure). This observation was still consistent even after adjusting clinical demographics and comorbidity [hazard ratio = 2.95, 95% CI: 1.30–6.87, p=0.01]. Table 1 Lower SBP group (n=36) Higher SBP group (n=51) P-value Atrial fibrillation (%) 72.2 0.01 0.01 Loop diuretic (%) 97.1 83.7 0.08 MRA (%) 47.1 24.5 0.04 Beta-blocker (%) 52.9 44.9 0.51 ACE inhibitor/ARB (%) 59.2 29.4 0.01 Figure 1 Conclusions In octogenarian patients with acute decompensated HF and preserved LVEF, SBP on admission less than 140 mmHg is significantly associated with poor outcomes. Future studies need to prospectively evaluate optimal SBP treatment goals in very elderly patients with HFpEF.

Sudden Cardiac Death in Heart Failure Patients With Preserved Ejection Fraction

2012 ◽  
Vol 18 (10) ◽  
pp. 749-754 ◽  
Author(s):  
Selcuk Adabag ◽  
Lindsay G. Smith ◽  
Inder S. Anand ◽  
Alan K. Berger ◽  
Russell V. Luepker
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Cardiac Death ◽  
Preserved Ejection Fraction ◽  
Heart Failure Patients

Abstract P308: Lower Neighborhood Socioeconomic Status is Associated with Higher BNP and Prolonged QTc Intervals among Heart Failure Patients with Preserved Ejection Fraction

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Norrina B Allen ◽  
Sylvia Badon ◽  
Sanjiv J Shah
Keyword(s):  
Heart Failure ◽  
Socioeconomic Status ◽  
Sudden Cardiac Death ◽  
Ejection Fraction ◽  
Census Tract ◽  
Cardiac Death ◽  
Nyha Class ◽  
Qtc Interval ◽  
Preserved Ejection Fraction ◽  
Neighborhood Socioeconomic Status

Background: Prior studies have shown that high B-type natriuretic peptide (BNP) levels and prolonged QTc intervals are associated with increased mortality, particularly sudden cardiac death, among heart failure (HF) patients. Whether neighborhood socioeconomic status (nSES) impacts BNP or QTc remains unknown. Methods: This study included consecutive patients enrolled from the outpatient clinic of the Northwestern Heart Failure with Preserved Ejection Fraction (HFpEF) Program from June 2007 to November 2010 after hospitalization for HF and followed through May 2011. Patients’ residential addresses were geocoded to identify their census tract of residence. Census 2000 data were used to create a single, summary score of nSES based on residential income, education and employment for each census tract and was divided into tertiles. Outcomes included post-discharge BNP and QTc, obtained within 1 month after HF hospitalization during the outpatient HFpEF clinic visit GEE models were used to examine the association between nSES and BNP and QTc adjusting for age, race, gender, NYHA class, blood pressure, obesity, smoking, glucose, eGFR, and comorbidities. Results: Among the 368 HFpEF patients, 37.0% were female, 50.5% White, avg. age was 64.8 yrs and 45.9% had NYHA class 3+. Higher nSES was significantly associated with lower BNP levels and shorter QTc intervals (Table). The adjusted BNP levels per nSES tertile were 718 pg/mL (±101.4) for the lowest nSES tertile, 508 pg/mL (± 75.3) for the intermediate nSES tertile and 454.2 pg/mL for the highest nSES tertile. Simlarly, QTc interval decreased with increasing tertile of nSES from 464.1 ms (± 5.7) in the lowest nSES tertile to 457.2 ms (± 5.8) and 448.9 ms (± 5.4) for the intermediate and highest tertiles, respectively. Conclusion: Low nSES is associated with increased BNP levels and a longer QTc interval in HFpEF patients. These findings may explain the association of nSES with higher rates of sudden cardiac death and worse outcomes among HF patients in disadvantaged neighborhoods.

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