Heart and Vessels

, Volume 26, Issue 3, pp 313–320 | Cite as

Prognostic importance of comorbidities in heart failure with preserved left ventricular ejection fraction

  • Sylvestre Maréchaux
  • Marie M. Six-Carpentier
  • Nadia Bouabdallaoui
  • David Montaigne
  • Jean Jacques Bauchart
  • Frédéric Mouquet
  • Jean Luc Auffray
  • Thierry Le Tourneau
  • Philippe Asseman
  • Thierry H. LeJemtel
  • Pierre Vladimir Ennezat
Original Article

Abstract

The relative impact of comorbidities and parameters of left ventricular diastolic function on clinical outcome has not been thoroughly investigated in patients who are hospitalized for heart failure decompensation and found to have preserved ejection fraction. We identified 98 HFpEF patients among 1452 patients admitted with acute heart failure. Clinical characteristics, hemoglobin levels, estimated glomerular filtration rate (eGFR), B-type natriuretic peptide (BNP) and Doppler-echocardiographic parameters were analyzed. The primary end point of the study combined death and rehospitalization for decompensated heart failure after the index hospitalization. Mean age was 76 ± 9 years. LV ejection fraction, E/Ea ratio, and estimated systolic pulmonary artery pressure were 61 (55–67)%, 12.9 (9.4–15.1), 40 (32–46) mmHg, respectively. BNP values, hemoglobin and eGFR were 287 (164–562) pg/mL, 11.3 (10.4–12.4) g/dL and 45 (37–74) mL/min/m2, respectively. During a mean follow-up of 17 ± 11 months, 56% reached the primary endpoint of the study: 31 died and 24 were re-hospitalizated for heart failure. Diabetes [HR = 1.76 (1.03–3.00), P = 0.039], lower systolic blood pressure [HR = 0.99 (0.97–0.99), P = 0.016], hemoglobin [HR = 0.62 (0.49–0.76), P < 0.0001], and eGFR [HR = 0.98 (0.97–0.99), P = 0.004] were associated with a poor outcome. Neither BNP nor echocardiographic parameters were correlated with outcome. Comorbidities primarily correlate with outcome in patients with HFpEF.

Keywords

Prognosis Heart failure Anemia Kidney disease 

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Copyright information

© Springer 2010

Authors and Affiliations

  • Sylvestre Maréchaux
    • 1
    • 2
  • Marie M. Six-Carpentier
    • 1
    • 2
  • Nadia Bouabdallaoui
    • 1
    • 2
  • David Montaigne
    • 1
    • 2
  • Jean Jacques Bauchart
    • 1
    • 2
  • Frédéric Mouquet
    • 1
    • 2
  • Jean Luc Auffray
    • 1
    • 2
  • Thierry Le Tourneau
    • 1
    • 2
  • Philippe Asseman
    • 1
    • 2
  • Thierry H. LeJemtel
    • 3
  • Pierre Vladimir Ennezat
    • 1
    • 2
    • 4
  1. 1.Division of CardiologyCentre Hospitalier Régional et Universitaire de LilleLilleFrance
  2. 2.Faculté de médecineUniversité de Lille 2LilleFrance
  3. 3.Division of CardiologyTulane University School of MedicineNew OrleansUSA
  4. 4.Cardiology Intensive Care UnitCardiology HospitalLille CedexFrance

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