Younger‐ vs Older‐Old Patients with Heart Failure with Preserved Ejection Fraction

Matsushita, Kenichi; Harada, Kazumasa; Miyazaki, Tatsuya; Miyamoto, Takamichi; Kohsaka, Shun; Iida, Kiyoshi; Yamamoto, Yoshiya; Nagatomo, Yuji; Yoshino, Hideaki; Yamamoto, Takeshi; Nagao, Ken; Takayama, Morimasa

doi:10.1111/jgs.16050

Cited by 12 publications

(8 citation statements)

References 48 publications

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“…Patients with HAD were significantly older; had higher blood urine nitrogen, NT-pro BNP and C-reactive protein levels, and proportion of NYHA class ≥III; had longer hospital stay; and had lower body mass index, albumin level, geriatric nutritional risk index, BI score before admission and BI score, gait speed, and short physical performance battery score at discharge, and return to home rate than those without HAD. In addition, the median (interquartile range) time of initiation of acute phase of physiotherapy progression; Steps 1 and 2 (2-4) vs. 2 (1-3); Step 2 and 3 (2-5) vs. 2 (1-4); Steps 3 and 5 (3)(4)(5)(6)(7)(8) vs. 3 (1-5): P < 0.001, respectively, was well as lower prevalence of early ambulation were related to the HAD. Patients with HAD had also a significantly higher MAGGIC risk score than those without HAD.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Prognostic impact of hospital‐acquired disability in elderly patients with heart failure

et al. 2021

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Aims Functional decline is associated with worse outcomes in patients with elderly heart failure (HF), but little is known about the prognostic impact of hospital-acquired disability (HAD) during hospital stay after acute HF. The present study examines the prognostic significance of HAD in the prediction of all-cause mortality in elderly patients who admitted for acute HF.Methods and results This retrospective study was performed in 1941 elderly patients aged ≥65 years or older from the cardiovascular physiotherapy for acute HF patients in the Tokyo metropolitan area registry and excluded those who died in hospital. HAD was defined as any decline in the Barthel index (BI) before discharge compared with the BI within 1 month before hospital admission. The primary outcome of this study was all-cause death and HF readmission. A total of 565 (29%) deaths and 789 (41%) HF readmission occurred over a median follow-up period of 1.7 years. A total of 476 patients (25%) had HAD during hospital stay after acute HF. In multivariable analysis, HAD predicted all-cause death [hazard ratio (HR): 1.772; 95% confidence interval (CI): 1.450-2.167; P < 60; 0.001] and with risk of HF readmission (HR: 1.193; 95% CI: 1.005-1.416; P = 0.043) after adjusting for the Meta-analysis Global Group in Chronic Heart Failure risk score. Conclusions Hospital-acquired disability is associated with an increased risk of all-cause death and readmission for HF in elderly patients with acute HF.

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Section: Baseline Characteristicsmentioning

confidence: 99%

Prognostic impact of hospital‐acquired disability in elderly patients with heart failure

et al. 2021

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“…However, the prevalence may differ based on race. Previous reports have indicated that the prevalence of COPD is lower in Asia, where it ranged from 5% to 8% [ 5 , 14 ]. Considering these findings, the prevalence of COPD patients in our study might be appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, COPD has been reported to be a worse long-term predictor in the setting of HF [3]. There are also differences in the prevalence of COPD [5,13,14] and sensitivity for beta-blockers [15,16] among different races and regions. Although such diversity may affect the clinical course of HF patients with COPD, there is little evidence in East Asian populations.…”

Section: Introductionmentioning

confidence: 99%

Different Impact of Beta-Blockers on Long-Term Mortality in Heart Failure Patients with and without Chronic Obstructive Pulmonary Disease

Higuchi

Kohno

Kohsaka

et al. 2021

JCM

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The administration of beta-blockers is challenging and their efficacy is unclear in heart failure (HF) patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the association of beta-blockers with mortality in such patients. This multicenter observational cohort study included hospitalized HF patients with a left ventricular ejection fraction <50% and evaluated them retrospectively. COPD was diagnosed based on medical records and/or the clinical judgment of each investigator. The study endpoints were two-year all-cause, cardiac, and non-cardiac mortality. This study included 83 patients with COPD and 1760 patients without. Two-year all-cause, cardiac, and non-cardiac mortality were observed in 315 (17%), 149 (8%), and 166 (9%) patients, respectively. Beta-blockers were associated with lower all-cause mortality regardless of COPD (COPD: hazard ratio [HR] 0.39, 95% CI 0.16–0.98, p = 0.044; non-COPD: HR 0.62, 95% CI 0.46–0.83, p = 0.001). This association in HF patients with COPD persisted after multivariate analysis and inverse probability weighting and was due to lower non-cardiac mortality (HR 0.40, 95% CI 0.14–1.18. p = 0.098), not cardiac mortality (HR 0.37, 95% CI 0.07–2.01, p = 0.248). Beta-blockers were associated with lower all-cause mortality in HF patients with COPD due to lower non-cardiac mortality. This may reflect selection biases in beta-blocker prescription.

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“…The design of the Tokyo CCU Network Database has been previously reported. 13 , 14 , 15 Briefly, this is an ongoing multicentre registry that prospectively collects information on emergency admissions to acute cardiac facilities of major hospitals in the Tokyo metropolitan area (72 facilities), serving a population of 13 million individuals. Ethical approval was obtained from the Institutional Review Board of Tokyo CCU Network Scientific Committee.…”

Section: Methodsmentioning

confidence: 99%

Association of ambient temperature and acute heart failure with preserved and reduced ejection fraction

et al. 2022

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Aims Evidence on the association between ambient temperature and the onset of acute heart failure (AHF) is scarce and mixed. We sought to investigate the incidence of AHF admissions based on ambient temperature change, with particular interest in detecting the difference between AHF with preserved (HFpEF), mildly reduced (HFmrEF), and reduced ejection fraction (HFrEF). Methods and results Individualized AHF admission data from January 2015 to December 2016 were obtained from a multicentre registry (Tokyo CCU Network Database). The primary event was the daily number of admissions. A linear regression model, using the lowest ambient temperature as the explanatory variable, was selected for the best‐estimate model. We also applied the cubic spline model using five knots according to the percentiles of the distribution of the lowest ambient temperature. We divided the entire population into HFpEF + HFmrEF and HFrEF for comparison. In addition, the in‐hospital treatment and mortality rates were obtained according to the interquartile ranges (IQRs) of the lowest ambient temperature (IQR1 <5.5°C; IQR25.5–13.3°C; IQR3 13.3–19.7°C; and IQR4 >19.7°C). The number of admissions for HFpEF, HFmrEF and HFrEF were 2736 (36%), 1539 (20%), and 3354 (44%), respectively. The lowest ambient temperature on the admission day was inversely correlated with the admission frequency for both HFpEF + HFmrEF and HFrEF patients, with a stronger correlation in patients with HFpEF + HFmrEF (R2 = 0.25 vs. 0.05, P < 0.001). In the sensitivity analysis, the decrease in the ambient temperature was associated with the greatest incremental increases in HFpEF, followed by HFmrEF and HFrEF patients (3.5% vs. 2.8% vs. 1.5% per −1°C, P < 0.001), with marked increase in admissions of hypertensive patients (systolic blood pressure >140 mmHg vs. 140–100 mmHg vs. <100 mmHg, 3.0% vs. 2.0% vs. 0.8% per −1°C, P for interaction <0.001). A mediator analysis indicated the presence of the mediator effect of systolic blood pressure. The in‐hospital mortality rate (7.5%) did not significantly change according to ambient temperature (P = 0.62). Conclusions Lower ambient temperature was associated with higher frequency of AHF admissions, and the effect was more pronounced in HFpEF and HFmrEF patients than in those with HFrEF.

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Younger‐ vs Older‐Old Patients with Heart Failure with Preserved Ejection Fraction

Cited by 12 publications

References 48 publications

Prognostic impact of hospital‐acquired disability in elderly patients with heart failure

Prognostic impact of hospital‐acquired disability in elderly patients with heart failure

Different Impact of Beta-Blockers on Long-Term Mortality in Heart Failure Patients with and without Chronic Obstructive Pulmonary Disease

Association of ambient temperature and acute heart failure with preserved and reduced ejection fraction

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