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Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis.

Publication ,  Conference
Lekavich, CL; Barksdale, DJ; Wu, J-R; Neelon, V; Crandell, J; Velazquez, EJ
Published in: J Card Fail
September 2017

BACKGROUND: Evidence continues to demonstrate increasing prevalence, cost, and mortality implications of heart failure with preserved ejection fraction (HFpEF), but clearly defined parameters that distinguish between control subjects and HFpEF have not been established. OBJECTIVES: This study was designed to detect differences in markers associated with Ventricular-arterial coupling and HFpEF when comparing matched case and control groups. METHODS: A study cohort of case (incident patients with HFpEF; n = 155) and matched control (patients with no prior heart failure; n = 155) groups was retrospectively identified. Matching criteria included race, sex, age, and date of echocardiography (within 1 year). Physiologic and echocardiographic markers were collected from previously acquired transthoracic echocardiograms. These echocardiographic images were reanalyzed, and measures of ventricular-arterial coupling were calculated. Using conditional logistic regression and controlling for covariates, models were fitted to detect differences in HFpEF markers between case and control subjects. RESULTS: Statistically significant differences in markers that reflect ventricular elastance (Ees; P = .007) and left atrial diameter (LAdiam; P = .04) were detected when comparing the case and control groups. Conditional logistic regression analyses suggested a 40% higher odds of being in the case group with every 1-unit increase in Ees (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.10-1.79) and a 2.92 times higher odds of being in the case group for every 1 cm increase in LAdiam (OR 2.92, 95% CI 1.064-7.994). CONCLUSIONS: Ees and LAdiam are easily measurable echocardiographic markers that may have a role in identifying and tracking the progression toward incident HFpEF without increasing cost or risk to the patient. Prospective studies are indicated to explore the use of Ees and LAdiam as predictors of impending HFpEF.

Duke Scholars

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

September 2017

Volume

23

Issue

9

Start / End Page

659 / 665

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Heart Failure
  • Female
  • Cohort Studies
 

Citation

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Lekavich, C. L., Barksdale, D. J., Wu, J.-R., Neelon, V., Crandell, J., & Velazquez, E. J. (2017). Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis. In J Card Fail (Vol. 23, pp. 659–665). United States. https://doi.org/10.1016/j.cardfail.2017.07.395
Lekavich, Carolyn L., Debra J. Barksdale, Jia-Rong Wu, Virginia Neelon, Jamie Crandell, and Eric J. Velazquez. “Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis.” In J Card Fail, 23:659–65, 2017. https://doi.org/10.1016/j.cardfail.2017.07.395.
Lekavich CL, Barksdale DJ, Wu J-R, Neelon V, Crandell J, Velazquez EJ. Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis. In: J Card Fail. 2017. p. 659–65.
Lekavich, Carolyn L., et al. “Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis.J Card Fail, vol. 23, no. 9, 2017, pp. 659–65. Pubmed, doi:10.1016/j.cardfail.2017.07.395.
Lekavich CL, Barksdale DJ, Wu J-R, Neelon V, Crandell J, Velazquez EJ. Measures of Ventricular-Arterial Coupling and Incident Heart Failure With Preserved Ejection Fraction: A Matched Case-Control Analysis. J Card Fail. 2017. p. 659–665.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

September 2017

Volume

23

Issue

9

Start / End Page

659 / 665

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Heart Failure
  • Female
  • Cohort Studies