1
|
Lopes LR, Losi MA, Sheikh N, Laroche C, Charron P, Gimeno J, Kaski JP, Maggioni AP, Tavazzi L, Arbustini E, Brito D, Celutkiene J, Hagege A, Linhart A, Mogensen J, Garcia-Pinilla JM, Ripoll-Vera T, Seggewiss H, Villacorta E, Caforio A, Elliott PM, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Erlinge D, Emberson J, Glikson M, Gray A, Kayikcioglu M, Maggioni A, Nagy KV, Nedoshivin A, Petronio AS, Hesselink JR, Wallentin L, Zeymer U, Caforio A, Blanes JRG, Charron P, Elliott P, Kaski JP, Maggioni AP, Tavazzi L, Tendera M, Komissarova S, Chakova N, Niyazova S, Linhart A, Kuchynka P, Palecek T, Podzimkova J, Fikrle M, Nemecek E, Bundgaard H, Tfelt-Hansen J, Theilade J, Thune JJ, Axelsson A, Mogensen J, Henriksen F, Hey T, Nielsen SK, Videbaek L, Andreasen S, Arnsted H, Saad A, Ali M, Lommi J, Helio T, Nieminen MS, Dubourg O, Mansencal N, Arslan M, Tsieu VS, Damy T, Guellich A, Guendouz S, Tissot CM, Lamine A, Rappeneau S, Hagege A, Desnos M, Bachet A, Hamzaoui M, Charron P, Isnard R, Legrand L, Maupain C, Gandjbakhch E, Kerneis M, Pruny JF, Bauer A, Pfeiffer B, Felix SB, Dorr M, Kaczmarek S, Lehnert K, Pedersen AL, Beug D, Bruder M, Böhm M, Kindermann I, Linicus Y, Werner C, Neurath B, Schild-Ungerbuehler M, Seggewiss H, Pfeiffer B, Neugebauer A, McKeown P, Muir A, McOsker J, Jardine T, Divine G, Elliott P, Lorenzini M, Watkinson O, Wicks E, Iqbal H, Mohiddin S, O'Mahony C, Sekri N, Carr-White G, Bueser T, Rajani R, Clack L, Damm J, Jones S, Sanchez-Vidal R, Smith M, Walters T, Wilson K, Rosmini S, Anastasakis A, Ritsatos K, Vlagkouli V, Forster T, Sepp R, Borbas J, Nagy V, Tringer A, Kakonyi K, Szabo LA, Maleki M, Bezanjani FN, Amin A, Naderi N, Parsaee M, Taghavi S, Ghadrdoost B, Jafari S, Khoshavi M, Rapezzi C, Biagini E, Corsini A, Gagliardi C, Graziosi M, Longhi S, Milandri A, Ragni L, Palmieri S, Olivotto I, Arretini A, Castelli G, Cecchi F, Fornaro A, Tomberli B, Spirito P, Devoto E, Bella PD, Maccabelli G, Sala S, Guarracini F, Peretto G, Russo MG, Calabro R, Pacileo G, Limongelli G, Masarone D, Pazzanese V, Rea A, Rubino M, Tramonte S, Valente F, Caiazza M, Cirillo A, Del Giorno G, Esposito A, Gravino R, Marrazzo T, Trimarco B, Losi MA, Di Nardo C, Giamundo A, Musella F, Pacelli F, Scatteia A, Canciello G, Caforio A, Iliceto S, Calore C, Leoni L, Marra MP, Rigato I, Tarantini G, Schiavo A, Testolina M, Arbustini E, Di Toro A, Giuliani LP, Serio A, Fedele F, Frustaci A, Alfarano M, Chimenti C, Drago F, Baban A, Calò L, Lanzillo C, Martino A, Uguccioni M, Zachara E, Halasz G, Re F, Sinagra G, Carriere C, Merlo M, Ramani F, Kavoliuniene A, Krivickiene A, Tamuleviciute-Prasciene E, Viezelis M, Celutkiene J, Balkeviciene L, Laukyte M, Paleviciute E, Pinto Y, Wilde A, Asselbergs FW, Sammani A, Van Der Heijden J, Van Laake L, De Jonge N, Hassink R, Kirkels JH, Ajuluchukwu J, Olusegun-Joseph A, Ekure E, Mizia-Stec K, Tendera M, Czekaj A, Sikora-Puz A, Skoczynska A, Wybraniec M, Rubis P, Dziewiecka E, Wisniowska-Smialek S, Bilinska Z, Chmielewski P, Foss-Nieradko B, Michalak E, Stepien-Wojno M, Mazek B, Lopes LR, Almeida AR, Cruz I, Gomes AC, Pereira AR, Brito D, Madeira H, Francisco AR, Menezes M, Moldovan O, Guimaraes TO, Silva D, Ginghina C, Jurcut R, Mursa A, Popescu BA, Apetrei E, Militaru S, Coman IM, Frigy A, Fogarasi Z, Kocsis I, Szabo IA, Fehervari L, Nikitin I, Resnik E, Komissarova M, Lazarev V, Shebzukhova M, Ustyuzhanin D, Blagova O, Alieva I, Kulikova V, Lutokhina Y, Pavlenko E, Varionchik N, Ristic AD, Seferovic PM, Veljic I, Zivkovic I, Milinkovic I, Pavlovic A, Radovanovic G, Simeunovic D, Zdravkovic M, Aleksic M, Djokic J, Hinic S, Klasnja S, Mircetic K, Monserrat L, Fernandez X, Garcia-Giustiniani D, Larrañaga JM, Ortiz-Genga M, Barriales-Villa R, Martinez-Veira C, Veira E, Cequier A, Salazar-Mendiguchia J, Manito N, Gonzalez J, Fernández-Avilés F, Medrano C, Yotti R, Cuenca S, Espinosa MA, Mendez I, Zatarain E, Alvarez R, Pavia PG, Briceno A, Cobo-Marcos M, Dominguez F, Galvan EDT, Pinilla JMG, Abdeselam-Mohamed N, Lopez-Garrido MA, Hidalgo LM, Ortega-Jimenez MV, Mezcua AR, Guijarro-Contreras A, Gomez-Garcia D, Robles-Mezcua M, Blanes JRG, Castro FJ, Esparza CM, Molina MS, García MS, Cuenca DL, de Mallorca P, Ripoll-Vera T, Alvarez J, Nunez J, Gomez Y, Fernandez PLS, Villacorta E, Avila C, Bravo L, Diaz-Pelaez E, Gallego-Delgado M, Garcia-Cuenllas L, Plata B, Lopez-Haldon JE, Pena Pena ML, Perez EMC, Zorio E, Arnau MA, Sanz J, Marques-Sule E. Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:42-53. [PMID: 35138368 PMCID: PMC9745665 DOI: 10.1093/ehjqcco/qcac006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
AIMS The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry. METHODS AND RESULTS 1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients. CONCLUSION Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.
Collapse
Affiliation(s)
- Luis R Lopes
- Corresponding author. Tel: +447765109343, , Twitter handle: @LuisRLopesDr
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II, Corso Umberto I, 40, Naples 80138, Italy
| | - Nabeel Sheikh
- Department of Cardiology and Division of Cardiovascular Sciences, Guy's and St. Thomas’ Hospitals and King's College London, Strand, London WC2R 2LS, UK
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | | | | | - Juan P Kaski
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Aldo P Maggioni
- EORP, European Society of Cardiology, Sophia-Antipolis, France,Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | | | - Dulce Brito
- Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1169-050, Portugal,CCUL, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal
| | - Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Universiteto g. 3, Vilnius 01513, Lithuania,State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Ales Linhart
- 2nd Department of Internal Cardiovascular Medicine, General University Hospital and First Medical Faculty, Charles University, Opletalova 38, Prague 110 00, Czech Republic
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - José Manuel Garcia-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares. Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. IBIMA. Málaga and Ciber-Cardiovascular. Instituto de Salud Carlos III. Madrid, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Disease Unit Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hubert Seggewiss
- Universitätsklinikum Würzburg, Deutsches Zentrum für Herzinsuffizienz (DZHI), Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Haus 15A, 97078 Wurzburg, Germany
| | - Eduardo Villacorta
- Member of National Centers of expertise for familial cardiopathies (CSUR), Cardiology Department, University Hospital of Salamanca. Institute of Biomedical Research of Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | | | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,St. Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Karaliute R, Mizariene V, Kazakevicius T, Jurgaityte J, Jureviciute J, Baksyte G, Kavoliuniene A. Value of tissue doppler indices for prediction of early atrial fibrillation recurrence after cardioversion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Spectral tissue Doppler-derived E/e' ratio has been proposed as the best parameter in the prediction of atrial fibrillation (AF). Although relaxation and contraction are equivalent parts of a continuous cardiac cycle, where systolic and diastolic abnormalities have a variable contribution to the left ventricle (LV) failure. A new doppler index, E/(e'×s') ratio, combining an index of diastolic function (E/e') and marker of systolic LV function (s'), has been confirmed as a good predictor of new-onset AF, although value of E/(e'×s') ratio to predict AF recurrence was not evaluated.
Purpose
The aim of this study was to investigate whether E/(e'×s') may be better parameter than E/e' to predict AF recurrence after the electrical cardioversion (ECV) of persistent AF in patients with normal LV function.
Methods
The prospective study included 77 patients with persistent AF with preserved LV ejection fraction (>50%) and successfully performed ECV. Plasma level of NT-proBNP was measured for all the patients before the ECV. Transthoracic echocardiography was performed within the first 24 hours after successful ECV. Primary outcome was the early (at 1 month) recurrence of AF.
Results
At 1 month follow-up, 39 patients (50.6%) were in sinus rhythm. Binary logistic regression analysis showed that LV enddiastolic diameter >50 mm (HR 3.70, 95% CI 1.29–10.58, p=0.02), NT-proBNP >2000 ng/L (HR 3.28, 95% CI 1.01–10.71, p=0.04), E/e' (HR 1.74, 95% CI 1.27–2.39, p=0.001) and E/(e'×s') ratios (HR 8.17, 95% CI 1.57–42.4, p=0.01) were significant predictors of AF early recurrence after ECV. When we developed multivariate models using these potential confounding factors. To minimize the problem of collinearity E/e'and E/(e'×s') were included in 2 separate models. Multivariate analysis identified that E/(e'×s') ratio and E/e' ratio in combination with LV enddiastolic diameter >49.3 mm and NT-proBNP >2000 ng/L are able to predict early AF recurrence after ECV in 74% and 79% cases, respectively. E/(e'×s') ratio showed higher contribution in the model to predict AF recurrence compared to E/e' ratio (for E/(e'×s') ratio HR 18.94, 95% CI 2.39–149.66, p=0.005; for E/e' ratio HR 1.95, 95% CI 1.31–2.91, p=0.001). On ROC analysis, the diagnostic accuracy of E/(e'×s') and E/e' ratios were found to have the largest areas under the curve (E/(e'×s') ratio, AUC = 0.71, p=0.002 and E/e' ratio, AUC = 0.75, p<0.0001) with an optimal E/(e'×s') ratio cut-off value of 1.15 (sensitivity 97%, specificity 58%) and E/e' ratio value of 8.79 (sensitivity 89%, specificity 41%) for predicting early recurrence of AF after ECV.
Conclusions
Spectral tissue Doppler-derived ratios (E/(e'×s') and E/e') together with higher NTproBNP level and larger LV enddiastolic diameter predicted early AF recurrence after ECV. E/(e'×s') seems to be a more powerful predictor of AF early recurrence than E/e' ratio.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- R Karaliute
- Lithuanian University of Health Sciences, Laboratory of Behavioral Medicine, Neuroscience Institute, Medical Academy, Kaunas, Lithuania
| | - V Mizariene
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| | - T Kazakevicius
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| | - J Jurgaityte
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| | - J Jureviciute
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| | - G Baksyte
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| | - A Kavoliuniene
- Lithuanian University of Health Sciences, Department of Cardiology, Medical Academy, Kaunas, Lithuania
| |
Collapse
|
3
|
Cerlinskaite K, Mebazaa A, Sadoune M, Motiejunaite J, Juknevicius V, Balciunas M, Bagdonaite L, Kavoliuniene A, Celutkiene J. Growth differentiation factor-15 significantly improves prognostication of short-term mortality in acute settings. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Acute dyspnoea is one of the most common complaints in the emergency department with a diverse range of diagnoses and a vastly different prognosis. There is still a need for a reliable biomarker for prognostication in acute settings.
Purpose
To evaluate and compare the role of three biomarkers, which represent different pathophysiological pathways, in stratifying short-term mortality risk in patients admitted to the emergency department with acute dyspnoea.
Methods
Prospective observational cohort enrolled 1455 acute dyspnoea patients admitted to emergency departments of two university centres from 2015 to 2017. The present study included 867 (71 [62–79] years, 40% female) patients who had N-terminal pro–B-type natriuretic peptide (NT-proBNP), high-sensitive troponin T (hsTnT) and growth differentiation factor 15 (GDF-15) measured at admission. Clinical variables known to affect prognosis (age, gender, use of beta blockers, angiotensin-converting-enzyme inhibitors/angiotensin II receptor blockers at admission, history of chronic heart failure, diabetes and coronary artery disease, systolic blood pressure, heart rate, creatinine, sodium, haemoglobin and C-reactive protein levels) were used to build a baseline model for all-cause 3-month mortality risk prediction in acute dyspnoea [“Clinical score”]. The ability of each biomarker to improve risk prediction on top of the Clinical score was evaluated by area under the curve (AUC), comparing AUC of the model with the biomarker to the AUC of the clinical model alone using the DeLong test. The clinical benefit in risk prediction of adding a biomarker was further assessed by reclassification analysis, including the net reclassification improvement (NRI) and the integrated discrimination index (IDI). The statistical analyses were performed using R statistical software. P value of <0.05 was considered statistically significant.
Results
Mortality at 3 months was 16% (143 patients). The AUC of the Clinical score was 0.787 [95% confidence interval (CI) 0.735 - 0.836]. GDF-15 was the only biomarker that significantly improved risk prediction on top of the Clinical score. The results of the individual biomarkers are displayed in Figure 1A. GDF-15 significantly reclassified 3-month mortality risk with an NRI of 32% [13%-51%] and an IDI of 0.026 [0.011–0.042]; other biomarkers had lower reclassification rates (Figure 1B).
Conclusions
This study demonstrates that the cellular stress biomarker GDF-15 taken at admission provides a substantial additive value to conventional clinical parameters for risk stratification in patients with acute dyspnoea.
Figure 1
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The work was supported by the Research Council of Lithuania (Lietuvos mokslo taryba), grant Nr. MIP-049/2015 and approved by Lithuanian Bioethics Committee, no. L-15-01. Roche Diagnostics supported the research with measurement of NT-proBNP, high-sensitivity troponin T and growth differentiation factor-15
Collapse
Affiliation(s)
- K Cerlinskaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Inserm UMR-S 942 and Anesthesia and Critical Care Department, Paris, France
| | | | - J Motiejunaite
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - V Juknevicius
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - M Balciunas
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - L Bagdonaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - A Kavoliuniene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| |
Collapse
|
4
|
Cerlinskaite K, Gabartaite D, Bugaite J, Verikas D, Krivickiene A, Motiejunaite J, Zaliaduonyte-Peksiene D, Zakarkaite D, Mebazaa A, Kavoliuniene A, Celutkiene J. P1648Prevalence of increased filling pressure assessed by echocardiography in acute dyspnoea cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Acute heart failure (AHF) is frequently associated with congestion leading to elevation of cardiac filling pressure. The present study investigates echocardiographic parameters of diastolic function in patients with AHF or non-AHF aetiology of acute dyspnoea.
Purpose
To determine the patterns of diastolic dysfunction in different profiles of acute dyspnoea.
Methods
Prospective multicentre observational study included 1455 acutely dyspnoeic patients in emergency departments from 2015 to 2017. Echocardiography was performed during the first 48 hours in 452 (31%) patients assessing left ventricular (LV) parameters. They were compared in four patient profiles based on dyspnoea cause and history of chronic HF (CHF): 1) AHF; 2) acute coronary syndrome without adjudicated AHF (Non-AHF+ACS); 3) non-AHF with CHF (Non-AHF+CHF); 4) other non-AHF patients (Non-AHF+other). Data were analysed using R statistical package.
Results
Significant differences in LV morphology and function were observed in the groups (Table 1). Increased LV filling pressure (E/E' >13) was found in most of AHF and Non-AHF+ACS patients, and in around 1/4 of Non-AHF+CHF group. Furthermore, more pronounced left-sided remodelling was observed in the first two groups. 1/3 of AHF patients had restrictive pattern of LV filling. Normal filling pressure dominated in Non-AHF+CHF and Non-AHF+other subgroups.
LV parameters in acute dyspnoea profiles Parameter AHF (n=291) Non-AHF + ACS (n=43) Non-AHF + CHF (n=44) Non-AHF + other (n=74) p value Age, years 71 [62–78] 72 [64–78] 71 [65–80] 68 [56–74] 0.045 LVEF, % 38 [25–55] 47 [32–55] 55 [45–55] 55 [50–55] <0.001 LV MMI, g/m2 126 [104.6–150.4] 99.1 [82.9–124] 94.4 [78.3–108.6] 79.6 [70.7–99.4] <0.001 LAVi, cm3 61.7 [50.9–81.1] 40.4 [35.5–46.8] 43.2 [39.8–58.9] 37.2 [32.6–43.8] <0.001 E/E' >13, % 57.7% 57.1% 23.1% 2.9% <0.001 E/E' <10, % 23.4% 38.1% 76.9% 70.6% <0.001 E/A >2, % 34.4% 14.8% 12.5% 3.9% <0.001 E/A <1, % 30.3% 59.3% 66.7% 74.5% <0.001 LVEF, left ventricular ejection fraction; LVdd, left ventricular diastolic diameter; LV MMI, left ventricular myocardial mass index; LAVi, left atrial volume index; AHF, acute heart failure; ACS, acute coronary syndrome; CHF, chronic heart failure.
Conclusions
Our data confirm the predominance of an increased cardiac filling pressure in acute heart failure patients, differently from chronic heart failure patients admitted due to other causes of dyspnoea. Patients with dyspnoea due to acute coronary syndrome frequently demonstrate elevated left-sided filling pressure.
Acknowledgement/Funding
The work was supported by the Research Council of Lithuania, grant Nr. MIP-049/2015 and approved by Lithuanian Bioethics Committee, Nr. L-15-01.
Collapse
Affiliation(s)
- K Cerlinskaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - D Gabartaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - J Bugaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - D Verikas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Krivickiene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Motiejunaite
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Zaliaduonyte-Peksiene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Zakarkaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Inserm UMR-S 942 and Anesthesia and Critical Care Department, Paris, France
| | - A Kavoliuniene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| |
Collapse
|
5
|
Cerlinskaite K, Mebazaa A, Cinotti R, Wussler DN, Gayat E, Juknevicius V, Muller C, Kavoliuniene A, Celutkiene J. P785Unplanned readmissions after discharge increases risk of death in acute dyspnoea patients: non-cardiac is as severe as cardiac causes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Acute dyspnoea is a major reason for admission to the emergency department and has been associated with high rates of readmission and mortality. However, the association of readmission with mortality risk has not been widely studied in patients with acute dyspnoea.
Purpose
To determine whether unplanned readmission during first 6 months after discharge is associated with greater risk of death within 1 year in patients with acute dyspnoea.
Methods
Derivation cohort consisted of 1371 patients from the prospective observational study, which enrolled acute dyspnoea patients admitted to emergency departments of two university centres from 2015 to 2017 and discharged alive from the hospital. Cox regression analysis compared 1-year risk of death between readmitted vs. non-readmitted patients in the first 6 months after discharge. In addition, we studied this association in 1986 patients from a multicentre validation cohort, which included acute dyspnoea patients from 2006 to 2014. Sensitivity analysis was done in the subgroups divided by cause of index admission (acute heart failure [AHF] and non-AHF) and cause of the first readmission (cardiovascular [CV] or non-CV). The statistical analyses were performed using R statistical software. P value of <0.05 was considered statistically significant.
Results
In the derivation cohort 666 (49%) of patients were readmitted at 6 months and 282 (21%) died in 1 year. Readmitted patients died more frequently than non-readmitted patients (211 [32%] vs. 71 [10%], respectively, p<0.001). All-cause 6-month readmission was associated with an increased 1-year risk of death in a multivariate analysis in both the derivation cohort (adjusted hazard ratio (aHR) 3 [95% confidence interval (CI) 2.2–4], p<0.001) and the validation cohort (aHR 1.8 [95% CI 1.4–2.2], p<0.001). Moreover, deleterious effect of readmission on 1-year survival was equally observed in AHF and non-AHF patients, independent of whether the reason of first readmission was cardiovascular or non-CV, in both study cohorts. The results are displayed in Figure 1.
Figure 1. Main results of the study
Conclusions
Our data demonstrates that readmission is associated with a markedly increased risk of death within 1 year in patients presenting to the emergency department with acute dyspnoea. Furthermore, the detrimental relationship between outcomes is similar in non-cardiac and cardiac causes.
Acknowledgement/Funding
The work was supported by the Research Council of Lithuania, grant Nr. MIP-049/2015 and approved by Lithuanian Bioethics Committee, Nr. L-15-01.
Collapse
Affiliation(s)
- K Cerlinskaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Inserm UMR-S 942 and Anesthesia and Critical Care Department, Paris, France
| | - R Cinotti
- University Hospital of Nantes, Department of Anesthesia and Critical Care, Nantes, France
| | - D N Wussler
- University Hospital Basel, Cardiology Department, Basel, Switzerland
| | - E Gayat
- Hospital Lariboisiere, Inserm UMR-S 942 and Anesthesia and Critical Care Department, Paris, France
| | - V Juknevicius
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - C Muller
- University Hospital Basel, Cardiology Department, Basel, Switzerland
| | - A Kavoliuniene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| |
Collapse
|
6
|
Cerlinskaite K, Bugaite J, Gabartaite D, Verikas D, Krivickiene A, Motiejunaite J, Zaliaduonyte-Peksiene D, Zakarkaite D, Mebazaa A, Kavoliuniene A, Celutkiene J. P5412Prevalence of RV failure assessed by echocardiography in acute dyspnoea cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Recently more attention has been placed on right ventricle (RV) parameters in acute settings. The present study investigates echocardiographic RV parameters in patients with acute heart failure (AHF) or non-AHF acute dyspnoea.
Purpose
To determine the patterns of RV injury in different profiles of acute dyspnoea.
Methods
Prospective multicentre observational study included 1455 acutely dyspnoeic patients from 2015 to 2017. RV focused echocardiography was performed during the first 48 hours in 452 (31%) patients. They were compared in three patient profiles based on cause of dyspnoea and history of chronic HF (CHF): 1) AHF; 2) Non-AHF with CHF (Non-AHF+CHF); 3) other non-AHF patients (Non-AHF+other).
Results
Significant differences in RV morphology and function were observed in the study groups (Table 1). RV global function assessed by tricuspid annular plane systolic excursion (TAPSE) and RV longitudinal shortening was mostly affected in AHF patients. This was accompanied by more enlarged RV and increased right atrial pressure (RAP), assessed by the inferior vena cava diameter and respiratory collapse. Less severely impaired RV function and increased RAP were also observed in non-AHF+CHF patients indicating RV involvement in the chronic disease. Normal RV parameters dominated in Non-AHF+other group, however pulmonary artery systolic pressure >40 mmHg was observed in all profiles, suggesting similar severity of pulmonary hypertension in cardiac or pulmonary causes of acute dyspnoea.
Table 1. RV parameters in acute dyspnoea profiles Parameter AHF (n=291) Non-AHF + CHF (n=73) Non-AHF + other (n=88) p value LVEF, % 38 [25–55] 50 [40–55] 55 [50–55] <0.001 RV basal diameter, cm 4.5 [3.9–5.2] 4 [3.5–4.5] 4 [3.5–4.55] <0.001 TAPSE, cm 1.5 [1.2–1.8] 1.8 [1.6–2] 2 [1.5–2.4] <0.001 RV free wall strain, -% −15.3 [−19; −11.24] −19.3 [−24.5; −15.78] −23 [−24.5; −19.69] <0.001 Entire RV strain, -% −12.03 [−15.17; −9.11] −16.4 [−19.31; −10.5] −18 [−18.75; −16.9] <0.001 PASP >40, % 66% 51% 50% 0.039 IVC diameter, cm 2.4 [2–2.8] 2 [1.7–2.4] 1.8 [1.4–2.3] <0.001 IVC collapse, % 34.9 [19.7–50.2] 44.1 [28.7–59.3] 52.6 [35–72.7] <0.001 LVEF, left ventricular ejection fraction; RV, right ventricle; TAPSE, tricuspid annular plane systolic excursion; PASP, pulmonary artery systolic pressure; IVC, inferior vena cava; AHF, acute heart failure; CHF, chronic heart failure.
Conclusions
Our data confirm more pronounced acute failure of right ventricle in acute heart failure patients than in chronic heart failure patients admitted due to other causes of dyspnoea. Pulmonary hypertension is present in a majority of the acute dyspnoea patients.
Acknowledgement/Funding
The work was supported by the Research Council of Lithuania, grant Nr. MIP-049/2015 and approved by Lithuanian Bioethics Committee, Nr. L-15-01.
Collapse
Affiliation(s)
- K Cerlinskaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - J Bugaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - D Gabartaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - D Verikas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Krivickiene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Motiejunaite
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Zaliaduonyte-Peksiene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Zakarkaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Inserm UMR-S 942 and Anesthesia and Critical Care Department, Paris, France
| | - A Kavoliuniene
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| |
Collapse
|
7
|
Verikas D, Bugaite J, Gabartaite D, Cerlinskaite K, Krivickiene A, Zaliaduonyte-Peksiene D, Kavoliuniene A, Mebazaa A, Celutkiene J. P3530Right ventricular remodelling as part of the cardiorenal syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The relationship of glomerular filtration rate (GFR) to the remodelling of right (RV) and left ventricle (LV) in acute settings is not well studied.
Purpose
To investigate the relationship of renal function to LV and RV echocardiographic parameters in acute dyspnoea patients.
Methods
Echocardiography was performed in 438 patients with acute dyspnoea in prospective multicentre observational study during the first 48 hours after presentation. Echocardiographic quantification included the following parameters: tricuspid annular plane systolic excursion (TAPSE), velocity of the tricuspid annular systolic motion (RV S'), RV fractional area change (FAC), RV basal diameter, entire RV strain, strain of free RV wall, inferior vena cava (IVC) and LV parameters. Patients were divided into groups according to the GFR (ml/min/1.73m2): Normal or mildly decreased GFR (≥60), moderately decreased GFR (30–59) and severely decreased GFR (≤29). Data were analysed using One-way ANOVA.
Results
Mean GFR in this cohort was 63±26 ml/min/1.73m2. The severity of RV remodelling and venous congestion was significantly different in three subgroups of renal dysfunction.
The distribution of parameters Normal or mildly decreased GFR Moderately decreased GFR Severely decreased GFR N=233 (52%) N=166 (38%) N=39 (9%) TAPSE (cm) 1.8±0.3 1.5±0.5 1.4±0.4* RV FAC (%) 41±15 38±13 29±12*§ RV S' (cm/s) 11.0±3.3 9.7±3.4 9.1±4.2*§ Strain of RV free wall (%) −19±7 −16±6 −13±5*§ Strain of entire RV (%) −15±5 −12±5 −11±5* IVC collapsibility (%) 46±26 38±25 36±28* PASP (mmHg) 44±16 48±15 51±16*§ LVEF (%) 43±15 38±14* 46±16§ LV internal diameter in diastole (cm) 4.6±2.1 4.3±2.3 4.4±2.0 LV myocardial mass index (g/m2) 119±40 122±39 114±25 NT-proBNP (ng/l) 1485 [471; 3409] 5282 [1499; 10695] 6677 [1971; 15522]*§ Troponin T (ng/l) 55±18 92±19* 95±12* Admitted due to AHF (%) 59 72* 67 Admitted due to pulmonary causes (%) 22 21 28 *p<0.05 compared to GFR ≥60 ml/min/1.73m2, §p<0.05 compared to GFR (30–59 ml/min/1.73m2).
Conclusions
The progressive impairment of renal function coupled with larger congestion is associated with a significant right-sided but not left-sided ventricular remodelling in acute dyspnoea patients.
Acknowledgement/Funding
The work was supported by the Research Council of Lithuania, grant Nr. MIP-049/2015 and approved by Lithuanian Bioethics Committee, Nr. L-15-01.
Collapse
Affiliation(s)
- D Verikas
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Bugaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - D Gabartaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - K Cerlinskaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - A Krivickiene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - A Kavoliuniene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Paris, France
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular Diseases, Centre of Cardiology and Angiology, Vilnius, Lithuania
| |
Collapse
|
8
|
Verikas D, Norvilaite R, Ziubryte G, Bugaite J, Gabartaite D, Krivickiene A, Motiejunaite J, Zaliaduonyte-Peksiene D, Jurgaitiene R, Cerlinskaite K, Balciunaite G, Zakarkaite D, Kavoliuniene A, Mebazaa A, Celutkiene J. P5685Right ventricular longitudinal strain is proportional to the right and left ventricular remodelling and severity of congestion. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Verikas
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - R Norvilaite
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - G Ziubryte
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - J Bugaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - D Gabartaite
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - A Krivickiene
- Lithuanian University of Health Sciences, Department of Cardiology, Kaunas, Lithuania
| | - J Motiejunaite
- Lithuanian University of Health Sciences, Department of Cardiology, Kaunas, Lithuania
| | | | - R Jurgaitiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Center of Cardiology and Angiology, Vilnius, Lithuania
| | - K Cerlinskaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Center of Cardiology and Angiology, Vilnius, Lithuania
| | - G Balciunaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Center of Cardiology and Angiology, Vilnius, Lithuania
| | - D Zakarkaite
- Vilnius University, Clinic of Cardiac and Vascular diseases, Center of Cardiology and Angiology, Vilnius, Lithuania
| | - A Kavoliuniene
- Lithuanian University of Health Sciences, Department of Cardiology, Kaunas, Lithuania
| | - A Mebazaa
- Hospital Lariboisiere, Paris, France
| | - J Celutkiene
- Vilnius University, Clinic of Cardiac and Vascular diseases, Center of Cardiology and Angiology, Vilnius, Lithuania
| | | |
Collapse
|
9
|
Targher G, Dauriz M, Laroche C, Temporelli PL, Hassanein M, Seferovic PM, Drozdz J, Ferrari R, Anker S, Coats A, Filippatos G, Crespo‐Leiro MG, Mebazaa A, Piepoli MF, Maggioni AP, Tavazzi L, Crespo‐Leiro M, Anker S, Coats A, Ferrari R, Filippatos G, Maggioni A, Mebazaa A, Piepoli M, Amir O, Chioncel O, Dahlström U, Jimenez JD, Drozdz J, Erglis A, Fazlibegovic E, Fonseca C, Fruhwald F, Gatzov P, Goncalvesova E, Hassanein M, Hradec J, Kavoliuniene A, Lainscak M, Logeart D, Merkely B, Metra M, Otljanska M, Seferovic P, Kostovska ES, Temizhan A, Tousoulis D, Andarala M, Ferreira T, Fiorucci E, Gracia G, Laroche C, Pommier C, Taylor C, Cuculici A, Gaulhofer C, Casado EP, Szymczyk E, Ramani F, Mulak G, Schou IL, Semenka J, Stojkovic J, Mehanna R, Mizarienne V, Auer J, Ablasser K, Fruhwald F, Dolze T, Brandner K, Gstrein S, Poelzl G, Moertl D, Reiter S, Podczeck‐Schweighofer A, Muslibegovic A, Vasilj M, Fazlibegovic E, Cesko M, Zelenika D, Palic B, Pravdic D, Cuk D, Vitlianova K, Katova T, Velikov T, Kurteva T, Gatzov P, Kamenova D, Antova M, Sirakova V, Krejci J, Mikolaskova M, Spinar J, Krupicka J, Malek F, Hegarova M, Lazarova M, Monhart Z, Hassanein M, Sobhy M, El Messiry F, El Shazly A, Elrakshy Y, Youssef A, Moneim A, Noamany M, Reda A, Dayem TA, Farag N, Halawa SI, Hamid MA, Said K, Saleh A, Ebeid H, Hanna R, Aziz R, Louis O, Enen M, Ibrahim B, Nasr G, Elbahry A, Sobhy H, Ashmawy M, Gouda M, Aboleineen W, Bernard Y, Luporsi P, Meneveau N, Pillot M, Morel M, Seronde M, Schiele F, Briand F, Delahaye F, Damy T, Eicher J, Groote P, Fertin M, Lamblin N, Isnard R, Lefol C, Thevenin S, Hagege A, Jondeau G, Logeart D, Le Marcis V, Ly J, Coisne D, Lequeux B, Le Moal V, Mascle S, Lotton P, Behar N, Donal E, Thebault C, Ridard C, Reynaud A, Basquin A, Bauer F, Codjia R, Galinier M, Tourikis P, Stavroula M, Tousoulis D, Stefanadis C, Chrysohoou C, Kotrogiannis I, Matzaraki V, Dimitroula T, Karavidas A, Tsitsinakis G, Kapelios C, Nanas J, Kampouri H, Nana E, Kaldara E, Eugenidou A, Vardas P, Saloustros I, Patrianakos A, Tsaknakis T, Evangelou S, Nikoloulis N, Tziourganou H, Tsaroucha A, Papadopoulou A, Douras A, Polgar L, Merkely B, Kosztin A, Nyolczas N, Nagy AC, Halmosi R, Elber J, Alony I, Shotan A, Fuhrmann AV, Amir O, Romano S, Marcon S, Penco M, Di Mauro M, Lemme E, Carubelli V, Rovetta R, Metra M, Bulgari M, Quinzani F, Lombardi C, Bosi S, Schiavina G, Squeri A, Barbieri A, Di Tano G, Pirelli S, Ferrari R, Fucili A, Passero T, Musio S, Di Biase M, Correale M, Salvemini G, Brognoli S, Zanelli E, Giordano A, Agostoni P, Italiano G, Salvioni E, Copelli S, Modena M, Reggianini L, Valenti C, Olaru A, Bandino S, Deidda M, Mercuro G, Dessalvi CC, Marino P, Di Ruocco M, Sartori C, Piccinino C, Parrinello G, Licata G, Torres D, Giambanco S, Busalacchi S, Arrotti S, Novo S, Inciardi R, Pieri P, Chirco P, Galifi MA, Teresi G, Buccheri D, Minacapelli A, Veniani M, Frisinghelli A, Priori S, Cattaneo S, Opasich C, Gualco A, Pagliaro M, Mancone M, Fedele F, Cinque A, Vellini M, Scarfo I, Romeo F, Ferraiuolo F, Sergi D, Anselmi M, Melandri F, Leci E, Iori E, Bovolo V, Pidello S, Frea S, Bergerone S, Botta M, Canavosio F, Gaita F, Merlo M, Cinquetti M, Sinagra G, Ramani F, Fabris E, Stolfo D, Artico J, Miani D, Fresco C, Daneluzzi C, Proclemer A, Cicoira M, Zanolla L, Marchese G, Torelli F, Vassanelli C, Voronina N, Erglis A, Tamakauskas V, Smalinskas V, Karaliute R, Petraskiene I, Kazakauskaite E, Rumbinaite E, Kavoliuniene A, Vysniauskas V, Brazyte‐Ramanauskiene R, Petraskiene D, Stankala S, Switala P, Juszczyk Z, Sinkiewicz W, Gilewski W, Pietrzak J, Orzel T, Kasztelowicz P, Kardaszewicz P, Lazorko‐Piega M, Gabryel J, Mosakowska K, Bellwon J, Rynkiewicz A, Raczak G, Lewicka E, Dabrowska‐Kugacka A, Bartkowiak R, Sosnowska‐Pasiarska B, Wozakowska‐Kaplon B, Krzeminski A, Zabojszcz M, Mirek‐Bryniarska E, Grzegorzko A, Bury K, Nessler J, Zalewski J, Furman A, Broncel M, Poliwczak A, Bala A, Zycinski P, Rudzinska M, Jankowski L, Kasprzak J, Michalak L, Soska KW, Drozdz J, Huziuk I, Retwinski A, Flis P, Weglarz J, Bodys A, Grajek S, Kaluzna‐Oleksy M, Straburzynska‐Migaj E, Dankowski R, Szymanowska K, Grabia J, Szyszka A, Nowicka A, Samcik M, Wolniewicz L, Baczynska K, Komorowska K, Poprawa I, Komorowska E, Sajnaga D, Zolbach A, Dudzik‐Plocica A, Abdulkarim A, Lauko‐Rachocka A, Kaminski L, Kostka A, Cichy A, Ruszkowski P, Splawski M, Fitas G, Szymczyk A, Serwicka A, Fiega A, Zysko D, Krysiak W, Szabowski S, Skorek E, Pruszczyk P, Bienias P, Ciurzynski M, Welnicki M, Mamcarz A, Folga A, Zielinski T, Rywik T, Leszek P, Sobieszczanska‐Malek M, Piotrowska M, Kozar‐Kaminska K, Komuda K, Wisniewska J, Tarnowska A, Balsam P, Marchel M, Opolski G, Kaplon‐Cieslicka A, Gil R, Mozenska O, Byczkowska K, Gil K, Pawlak A, Michalek A, Krzesinski P, Piotrowicz K, Uzieblo‐Zyczkowska B, Stanczyk A, Skrobowski A, Ponikowski P, Jankowska E, Rozentryt P, Polonski L, Gadula‐Gacek E, Nowalany‐Kozielska E, Kuczaj A, Kalarus Z, Szulik M, Przybylska K, Klys J, Prokop‐Lewicka G, Kleinrok A, Aguiar CT, Ventosa A, Pereira S, Faria R, Chin J, De Jesus I, Santos R, Silva P, Moreno N, Queirós C, Lourenço C, Pereira A, Castro A, Andrade A, Guimaraes TO, Martins S, Placido R, Lima G, Brito D, Francisco A, Cardiga R, Proenca M, Araujo I, Marques F, Fonseca C, Moura B, Leite S, Campelo M, Silva‐Cardoso J, Rodrigues J, Rangel I, Martins E, Correia AS, Peres M, Marta L, Silva GF, Severino D, Durao D, Leao S, Magalhaes P, Moreira I, Cordeiro AF, Ferreira C, Araujo C, Ferreira A, Baptista A, Radoi M, Bicescu G, Vinereanu D, Sinescu C, Macarie C, Popescu R, Daha I, Dan G, Stanescu C, Dan A, Craiu E, Nechita E, Aursulesei V, Christodorescu R, Otasevic P, Seferovic P, Simeunovic D, Ristic A, Celic V, Pavlovic‐Kleut M, Lazic JS, Stojcevski B, Pencic B, Stevanovic A, Andric A, Iric‐Cupic V, Jovic M, Davidovic G, Milanov S, Mitic V, Atanaskovic V, Antic S, Pavlovic M, Stanojevic D, Stoickov V, Ilic S, Ilic MD, Petrovic D, Stojsic S, Kecojevic S, Dodic S, Adic NC, Cankovic M, Stojiljkovic J, Mihajlovic B, Radin A, Radovanovic S, Krotin M, Klabnik A, Goncalvesova E, Pernicky M, Murin J, Kovar F, Kmec J, Semjanova H, Strasek M, Iskra MS, Ravnikar T, Suligoj NC, Komel J, Fras Z, Jug B, Glavic T, Losic R, Bombek M, Krajnc I, Krunic B, Horvat S, Kovac D, Rajtman D, Cencic V, Letonja M, Winkler R, Valentincic M, Melihen‐Bartolic C, Bartolic A, Vrckovnik MP, Kladnik M, Pusnik CS, Marolt A, Klen J, Drnovsek B, Leskovar B, Anguita MF, Page JG, Martinez FS, Andres J, Genis A, Mirabet S, Mendez A, Garcia‐Cosio L, Roig E, Leon V, Gonzalez‐Costello J, Muntane G, Garay A, Alcade‐Martinez V, Fernandez SL, Rivera‐Lopez R, Puga‐Martinez M, Fernandez‐Alvarez M, Serrano‐Martinez J, Crespo‐Leiro M, Grille‐Cancela Z, Marzoa‐Rivas R, Blanco‐Canosa P, Paniagua‐Martin M, Barge‐Caballero E, Cerdena IL, Baldomero IFH, Padron AL, Rosillo SO, Gonzalez‐Gallarza RD, Montanes OS, Manjavacas AI, Conde AC, Araujo A, Soria T, Garcia‐Pavia P, Gomez‐Bueno M, Cobo‐Marcos M, Alonso‐Pulpon L, Cubero JS, Sayago I, Gonzalez‐Segovia A, Briceno A, Subias PE, Hernandez MV, Cano MR, Sanchez MG, Jimenez JD, Garrido‐Lestache EB, Pinilla JG, Villa BG, Sahuquillo A, Marques RB, Calvo FT, Perez‐Martinez M, Gracia‐Rodenas M, Garrido‐Bravo IP, Pastor‐Perez F, Pascual‐Figal D, Molina BD, Orus J, Gonzalo FE, Bertomeu V, Valero R, Martinez‐Abellan R, Quiles J, Rodrigez‐Ortega J, Mateo I, ElAmrani A, Fernandez‐Vivancos C, Valero DB, Almenar‐Bonet L, Sanchez‐Lazaro I, Marques‐Sule E, Facila‐Rubio L, Perez‐Silvestre J, Garcia‐Gonzalez P, Ridocci‐Soriano F, Garcia‐Escriva D, Pellicer‐Cabo A, Fuente Galan L, Diaz JL, Platero AR, Arias J, Blasco‐Peiro T, Julve MS, Sanchez‐Insa E, Aured‐Guallar C, Portoles‐Ocampo A, Melin M, Hägglund E, Stenberg A, Lindahl I, Asserlund B, Olsson L, Dahlström U, Afzelius M, Karlström P, Tengvall L, Wiklund P, Olsson B, Kalayci S, Temizhan A, Cavusoglu Y, Gencer E, Yilmaz M, Gunes H. In‐hospital and 1‐year mortality associated with diabetes in patients with acute heart failure: results from the
ESC‐HFA
Heart Failure Long‐Term Registry. Eur J Heart Fail 2016; 19:54-65. [DOI: 10.1002/ejhf.679] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/24/2016] [Accepted: 09/20/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Giovanni Targher
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Marco Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University and Azienda Ospedaliera Universitaria Integrata of Verona Verona Italy
| | - Cécile Laroche
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
| | | | | | | | | | - Roberto Ferrari
- Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care & Research E.S: Health Science Foundation Cotignola Italy
| | - Stephan Anker
- Innovative Clinical Trials, Department of Cardiology & Pneumology University Medical Center Göttingen (UMG) Göttingen Germany
| | - Andrew Coats
- Monash University Australia and University of Warwick Coventry UK
| | | | - Maria G. Crespo‐Leiro
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Complexo Hospitalario Universitario A Coruna CHUAC La Coruna Spain
| | - Alexandre Mebazaa
- Inserm 942, Hôpital Lariboisière Université Paris Diderot Paris France
| | - Massimo F. Piepoli
- Department of Cardiology Polichirurgico Hospital G. da Saliceto Piacenza Italy
| | - Aldo Pietro Maggioni
- EURObservational Research Programme European Society of Cardiology Sophia‐Antipolis France
- ANMCO Research Center Florence Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care & Research E.S. Health Science Foundation Cotignola Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Sinkiewicz W, Glazer RD, Kavoliuniene A, Miglinas M, Prak H, Wernsing M, Yen J. Efficacy and tolerability of amlodipine/valsartan combination therapy in hypertensive patients not adequately controlled on valsartan monotherapy. Curr Med Res Opin 2009; 25:315-24. [PMID: 19192976 DOI: 10.1185/03007990802630588] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To demonstrate additional BP-lowering effects of amlodipine/valsartan combination in patients whose BP was not adequately controlled on valsartan alone. METHODS This was a multi-centre, randomised, double-blind, active-controlled study in patients with essential hypertension. After a washout period followed by a single-blind valsartan 160 mg run-in period, patients with mean sitting diastolic blood pressure (DBP) >or= 90 mmHg and < 110 mmHg were randomised to receive amlodipine/valsartan (10/160 mg or 5/160 mg o.d.) or valsartan (160 mg o.d.) for 8 weeks. TRIAL REGISTRATION NCT00170963 MAIN OUTCOME MEASURES: Primary efficacy variable was change from baseline in mean DBP at study end. Secondary efficacy variables included change from baseline in mean sitting systolic blood pressure (SBP), responder rate (mean DBP < 90 mmHg or >or= 10 mmHg reduction from baseline), and DBP control rate (mean DBP < 90 mmHg). Safety was also assessed. RESULTS Of 1136 patients enrolled in single-blind phase, 947 (mean age: 54.6 years) were randomised. Statistically significantly greater reductions in mean SBP/DBP were observed in both amlodipine/valsartan combinations (10/160 mg: 14.3/11.5 mmHg, 5/160 mg: 12.2/9.6 mmHg; both p < 0.0001) compared to valsartan 160 mg (8.3/6.7 mmHg). The 10/160 mg combination (p < 0.05) showed statistically significantly greater reductions in mean SBP/DBP compared to 5/160 mg (p < 0.001). Responder rates were higher in both combination therapy groups (10/160 mg: 81% [p < 0.0001]; 5/160 mg: 68% [p = 0.0018], respectively) compared to monotherapy (57%). Peripheral oedema was the most frequent adverse event, reported in amlodipine/valsartan 10/160 mg (9.1%), 5/160 mg (0.9%), and valsartan 160 mg (1.3%). CONCLUSIONS The combination of amlodipine/valsartan in this 8-week double-blind study provided additional BP control and was well-tolerated in patients inadequately controlled with valsartan monotherapy.
Collapse
Affiliation(s)
- W Sinkiewicz
- Department of Clinical Bases of Physiotherapy, University Nicolaus Copernicus in Torun, Poland.
| | | | | | | | | | | | | |
Collapse
|