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Differential interaction of clinical characteristics with key functional parameters in heart failure with preserved ejection fraction — Results of the Aldo-DHF trial

Edelmann, Frank ; Gelbrich, Götz ; Duvinage, André ; Stahrenberg, Raoul ; Behrens, Anneke ; Prettin, Christiane ; Kraigher-Krainer, Elisabeth ; Schmidt, Albrecht G. ; Düngen, Hans-Dirk ; Kamke, Wolfram ; Tschöpe, Carsten ; Herrmann-Lingen, Christoph ; Halle, Martin ; Hasenfuss, Gerd ; Wachter, Rolf ; Pieske, Burkert

International Journal of Cardiology, 30 November 2013, Vol.169(6), pp.408-417 [Tạp chí có phản biện]

ISSN: 0167-5273 ; DOI: 10.1016/j.ijcard.2013.10.018

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  • Nhan đề:
    Differential interaction of clinical characteristics with key functional parameters in heart failure with preserved ejection fraction — Results of the Aldo-DHF trial
  • Tác giả: Edelmann, Frank ; Gelbrich, Götz ; Duvinage, André ; Stahrenberg, Raoul ; Behrens, Anneke ; Prettin, Christiane ; Kraigher-Krainer, Elisabeth ; Schmidt, Albrecht G. ; Düngen, Hans-Dirk ; Kamke, Wolfram ; Tschöpe, Carsten ; Herrmann-Lingen, Christoph ; Halle, Martin ; Hasenfuss, Gerd ; Wachter, Rolf ; Pieske, Burkert
  • Chủ đề: Heart Failure With Preserved Ejection Fraction ; Aldosterone Receptor Blockade ; Exercise Capacity ; Diastolic Function ; Neurohumoral Activation
  • Là 1 phần của: International Journal of Cardiology, 30 November 2013, Vol.169(6), pp.408-417
  • Mô tả: BackgroundTo investigate the interaction of clinical characteristics with disease characterising parameters in heart failure with preserved ejection fraction (HFpEF).Methods and resultsIn the multicenter, randomized, placebo-controlled, double-blinded, Aldo-DHF trial investigating the effects of spironolactone on exercise capacity (peakVO2) and diastolic function (E/e′) n=422 patients with HFpEF (age 67±8years, 52% females, LVEF 67±8%) were included. After multiple adjustment, higher age was significantly related to reduced peakVO2, and to increased E/e′, NT-proBNP, LAVI as well as LVMI (all p<0.05). Female gender (p<0.001), CAD (p=0.002), BMI (p<0.001), sleep apnoea (p=0.02), and chronotropic incompetence (CI, p=0.002) were related to lower peakVO2 values. Higher pulse pressure (p=0.04), lower heart rates (p=0.03), CI (p=0.03) and beta-blocker treatment (p=0.001) were associated with higher E/e′. BMI correlated inversely (p=0.03), whereas atrial fibrillation (p<0.001), lower haemoglobin levels (p<0.001), CI (p=0.02), and beta-blocker treatment (p<0.001) were associated with higher NT-proBNP. After multiple adjustment for demographic and clinical variables peakVO2 was not significantly associated with E/e′ (r=+0.01, p=0.87), logNT-proBNP (r=0.09, p=0.08), LAVI (r=+0.03, p=0.55), and LVMI (r=+0.05, p=0.37). The associations of E/e′ with logNT-proBNP (r=0.21, p<0.001), LAVI (r=+0.29, p<0.001) and LVMI (r=0.09, p=0.06) were detectable also after multiple adjustment. ConclusionsDemographic and clinical characteristics differentially interact with exercise capacity, resting left ventricular filling index, neurohumoral activation, and left atrial and ventricular remodelling in HFpEF. Exercise intolerance in HFpEF is multi-factorial and therapeutic approaches addressing exercise capacity should therefore not only aim to improve single pathological mechanisms. Registration: ISRCTN94726526 (http://www.controlled-trials.com), Eudra-CT-number 2006-002605-31.
  • Ngôn ngữ: English
  • Số nhận dạng: ISSN: 0167-5273 ; DOI: 10.1016/j.ijcard.2013.10.018

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