Heart failure: Not only reduced left ventricular ejection fraction but also reserved ejection fraction!

Aydoğan, Mehmet; Balta, Şevket; Demırkol, Sait; Gümüş, Seyfettin; Arslan, Zekeriya; Ünlü, Murat

doi:10.1016/j.hrtlng.2013.01.001

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…However, limitations in the capture of comorbidity detail, especially in earlier DOPPS phases, preclude these analyses. Potentially informative information includes the duration of comorbidities such as hypertension and diabetes, as well as reduced vs. preserved ejection fraction in heart failure patients . Also, among coronary artery disease patients, the association of low BP with elevated mortality may be stronger if complicated by ischemic cardiomyopathy or recent myocardial infarction than in patients with medically controlled, otherwise uncomplicated angina.…”

Section: Discussionmentioning

confidence: 99%

“…Potentially informative information includes the duration of comorbidities such as hypertension and diabetes, as well as reduced vs. preserved ejection fraction in heart failure patients. 30 Also, among coronary artery disease patients, the association of low BP with elevated mortality may be stronger if complicated by ischemic cardiomyopathy or recent myocardial infarction than in patients with medically controlled, otherwise uncomplicated angina. Finally, the present study examined the association of BP with mortality in Japanese hemodialysis patients, not in other countries or racial groups.…”

Section: Figurementioning

confidence: 99%

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Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study

Inaba

Karaboyas

Akiba

et al. 2014

Hemodialysis International

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The association of low blood pressure (BP) with high mortality is a characteristic for hemodialysis patients. This analysis clarifies the association of BP with mortality and stroke in Japanese hemodialysis (HD) patients and examines the association separately for patients with and without antihypertensive medication (BP meds). We analyzed 9134 patients from Japan in phases 1-4 (1999-2011) of the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective cohort study of in-center HD patients. The association of patient systolic (SBP) and diastolic (DBP) blood pressure with all-cause and cause-specific mortality was assessed using adjusted Cox regression. A U-shaped association between BP and all-cause mortality was observed, with lowest mortality for baseline SBP 140-159 mmHg and DBP 65-74 mmHg. Both SBP and DBP were positively and monotonically associated with stroke-related death: hazard ratio (95% confidence interval) was 1.24 (1.01-1.53) per 20 mmHg higher SBP and 1.23 (1.05-1.44) per 10 mmHg higher DBP. No evidence of interaction was found between SBP and use of BP meds regarding all-cause mortality (P for interaction = 0.97); the association between SBP and stroke-related death was slightly stronger among patients not on BP meds than patients on BP meds (P for interaction = 0.09). In Japanese HD patients, both low and high BP are associated with all-cause mortality. This analysis also documents a positive and monotonic association of BP with stroke-related deaths. Although our analysis indicates that the prescription of BP meds to hypertensive patients might protect against stroke-related death, additional study is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study

Inaba

Karaboyas

Akiba

et al. 2014

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…Among HF patients, 30–60% have non‐dialysis HF with preserved ejection fraction (HFPEF), in which the patient's systolic function is maintained and diastolic dysfunction (DD) mainly causes HF in such patients. Despite the importance of DD, the concept of DD is not completely recognized yet . Moreover, despite the recent advances in the diagnosis and treatment of HF with reduced ejection fraction (HFREF) and consequent improvement in prognosis, the diagnosis of DD and HFPEF has been neglected .…”

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confidence: 99%

Relationship Between Diastolic Dysfunction and Atherosclerosis and Vascular Calcification in Hemodialysis Patients: Diagnostic Potential of the Cardio‐Ankle Vascular Index

et al. 2016

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Diastolic dysfunction (DD) commonly causes heart failure with preserved ejection fraction (EF). Here, we examine associations between DD severity and atherosclerosis/vascular calcification in hemodialysis patients. Echocardiography was performed on 101 patients undergoing hemodialysis therapy. Twelve patients (EF < 50% or chronic atrial fibrillation) were excluded; DD of the remaining 89 patients was classified into four grades. We then investigated the relationship between their DD grades and the cardio-ankle vascular index (CAVI), ankle-brachial pressure index (ABI), toe-brachial pressure index (TBI), and aortic calcification area index (ACAI). Seventy-seven patients (86.5%) with EF ≥ 50% had DD. Associations with advanced age and comorbid diabetes mellitus and cardiovascular disease were observed. The CAVI, TBI, and ACAI, but not ABI, increased proportionally with DD grades. Thus, many hemodialysis patients developed DD, with systolic function maintained. Strong associations between DD grades and progression of both atherosclerosis and vascular calcification could be inferred.

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Heart failure: Not only reduced left ventricular ejection fraction but also reserved ejection fraction!

Cited by 2 publications

References 11 publications

Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study

Association of blood pressure with all‐cause mortality and stroke in Japanese hemodialysis patients: The Japan dialysis outcomes and practice pattern study

Relationship Between Diastolic Dysfunction and Atherosclerosis and Vascular Calcification in Hemodialysis Patients: Diagnostic Potential of the Cardio‐Ankle Vascular Index

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