The Impact of Acute Heart Failure on Frailty Degree and Outcomes in Elderly Patients with Severe Aortic Stenosis and Chronic Heart Failure with Preserved Ejection Fraction

被引:1
作者
Esposito, Augusto [1 ]
Foffa, Ilenia [1 ,2 ]
Vecoli, Cecilia [1 ,2 ]
Bastiani, Luca [1 ,2 ]
Berti, Sergio [1 ,2 ]
Mazzone, Annamaria [1 ]
机构
[1] Fdn Toscana Gabriele Monasterio, I-54100 Massa, Italy
[2] CNR Inst Clin Physiol, I-54100 Massa, Italy
关键词
acute heart failure; multidisciplinary approach; frailty; elderly patients; severe aortic stenosis; hospitalization; mortality; OLDER PATIENTS; PROGNOSIS; ADULTS;
D O I
10.3390/jcdd11050150
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Frailty degree plays a critical role in the decision-making and outcomes of elderly patients with severe aortic stenosis (AS). Acute heart failure (AHF) results in a severely worse clinical hemodynamic status in this population. This study aimed to evaluate the impact of AHF on frailty degree and outcomes in older patients referred for tailored interventional treatment due to AS. A total of 109 patients (68% female; mean age 83.3 +/- 5.4), evaluated by a multidisciplinary path for "frailty-based management" of valve disease, were divided into two groups, one with (AHF+) and one without AHF (AHF-) and preserved ejection fraction (mean value EF: 57.4 +/- 8.6). AHF occurred a mean value of 55 days before geriatric, clinical, and surgical assessment. A follow-up for all-cause mortality and readmission was conducted at 20 months. AHF+ patients showed a higher frequency of advanced frailty (53.3% vs. 46.7%, respectively), rehospitalization (35.5% vs. 12.8; p = 0.007), and death (41.9% vs. 12.8%; p < 0.001). In stepwise logistic regression analysis, AHF emerged as an independent risk factor for advanced frailty (OR: 3.8 CI 1.3-10.7; p = 0.01) and hospital readmission (OR: 3.6 CI 1.1-11.6; p = 0.03). In addition, preceding AHF was an independent determinant associated with a higher risk of mortality (HR 2.65; CI 95% 1.04-6.74; p-value 0.04). AHF is independently associated with advanced frailty and poor outcomes in elderly patients with severe AS. So, this population needs careful clinical and geriatric monitoring and the implementation of interventional therapy for AS in the early stages of frailty to avoid the occurrence of AHF and poor outcomes.
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页数:10
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共 27 条
  • [1] Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement
    Auffret, Vincent
    Bakhti, Abdelkader
    Leurent, Guillaume
    Bedossa, Marc
    Tomasi, Jacques
    Belhaj Soulami, Reda
    Verhoye, Jean-Philippe
    Donal, Erwan
    Galli, Elena
    Loirat, Aurelie
    Sharobeem, Sam
    Sost, Gwenaelle
    Le Guellec, Marielle
    Boulmier, Dominique
    Le Breton, Herve
    [J]. CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2020, 13 (07)
  • [2] Pathophysiology of heart failure and frailty: a common inflammatory origin?
    Bellumkonda, Lavanya
    Tyrrell, Daniel
    Hummel, Scott L.
    Goldstein, Daniel R.
    [J]. AGING CELL, 2017, 16 (03) : 444 - 450
  • [3] Association of Chronic Heart Failure with Frailty, Malnutrition, and Sarcopenia Parameters in Older Patients-A Cross-Sectional Study in a Geriatric Ward
    Charkiewicz, Miroslaw
    Wojszel, Zyta Beata
    Kasiukiewicz, Agnieszka
    Magnuszewski, Lukasz
    Wojszel, Aleksandra
    [J]. JOURNAL OF CLINICAL MEDICINE, 2023, 12 (06)
  • [4] Diagnosis and Management of Malnutrition in Patients with Heart Failure
    Esteban-Fernandez, Alberto
    Villar-Taibo, Rocio
    Alejo, Mirian
    Arroyo, David
    Bonilla Palomas, Juan Luis
    Cachero, Montserrat
    Joaquin, Clara
    Mendez Bailon, Manuel
    Angel Perez-Rivera, Jose
    Carlos Romero-Vigara, Juan
    Somoza, Gema
    [J]. JOURNAL OF CLINICAL MEDICINE, 2023, 12 (09)
  • [5] Outcome of patients with heart failure after transcatheter aortic valve implantation
    Fischer-Rasokat, Ulrich
    Renker, Matthias
    Liebetrau, Christoph
    Weferling, Maren
    Rolf, Andreas
    Doss, Mirko
    Moellmann, Helge
    Walther, Thomas
    Hamm, Christian W.
    Kim, Won-Keun
    [J]. PLOS ONE, 2019, 14 (11):
  • [6] Frailty in older adults: Evidence for a phenotype
    Fried, LP
    Tangen, CM
    Walston, J
    Newman, AB
    Hirsch, C
    Gottdiener, J
    Seeman, T
    Tracy, R
    Kop, WJ
    Burke, G
    McBurnie, MA
    [J]. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2001, 56 (03): : M146 - M156
  • [7] Staging classification of aortic stenosis based on the extent of cardiac damage
    Genereux, Philippe
    Pibarot, Philippe
    Redfors, Bjorn
    Mack, Michael J.
    Makkar, Raj R.
    Jaber, Wael A.
    Svensson, Lars G.
    Kapadia, Samir
    Tuzcu, E. Murat
    Thourani, Vinod H.
    Babaliaros, Vasilis
    Herrmann, Howard C.
    Szeto, Wilson Y.
    Cohen, David J.
    Lindman, Brian R.
    McAndrew, Thomas
    Alu, Maria C.
    Douglas, Pamela S.
    Hahn, Rebecca T.
    Kodali, Susheel K.
    Smith, Craig R.
    Miller, D. Craig
    Webb, John G.
    Leon, Martin B.
    [J]. EUROPEAN HEART JOURNAL, 2017, 38 (45) : 3351 - +
  • [8] Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure
    Gerbaud, Edouard
    de la Poterie, Ambroise Bouchard
    Baudinet, Thomas
    Montaudon, Michel
    Beauvieux, Marie-Christine
    Lemaitre, Anne-Iris
    Cetran, Laura
    Seguy, Benjamin
    Picard, Francois
    Velayoudom, Fritz-Line
    Ouattara, Alexandre
    Kabore, Remi
    Coste, Pierre
    Domingues-Dos-Santos, Pierre
    Catargi, Bogdan
    [J]. JOURNAL OF CLINICAL MEDICINE, 2022, 11 (06)
  • [9] The Impact of Frailty Status on Survival After Transcatheter Aortic Valve Replacement in Older Adults With Severe Aortic Stenosis A Single-Center Experience
    Green, Philip
    Woglom, Abigail E.
    Genereux, Philippe
    Daneault, Benoit
    Paradis, Jean-Michel
    Schnell, Susan
    Hawkey, Marian
    Maurer, Mathew S.
    Kirtane, Ajay J.
    Kodali, Susheel
    Moses, Jeffrey W.
    Leon, Martin B.
    Smith, Craig R.
    Williams, Mathew
    [J]. JACC-CARDIOVASCULAR INTERVENTIONS, 2012, 5 (09) : 974 - 981
  • [10] Clinical characteristics and frailty status in heart failure with preserved vs. reduced ejection fraction
    Hamada, Tomoyuki
    Kubo, Toru
    Kawai, Kazuya
    Nakaoka, Yoko
    Yabe, Toshikazu
    Furuno, Takashi
    Yamada, Eisuke
    Kitaoka, Hiroaki
    [J]. ESC HEART FAILURE, 2022, 9 (03): : 1853 - 1863