Modes of death in patients with heart failure and preserved ejection fraction

被引:39
作者
Aschauer, Stefan [1 ]
Zotter-Tufaro, Caroline [1 ]
Duca, Franz [1 ]
Kammerlander, Andreas [1 ]
Dalos, Daniel [1 ]
Mascherbauer, Julia [1 ]
Bonderman, Diana [1 ]
机构
[1] Med Univ Vienna, Div Cardiol, Dept Internal Med 2, Waehringer Guertel 18-20, A-1090 Vienna, Austria
基金
奥地利科学基金会;
关键词
Right heart failure; Heart failure with preserved ejection fraction; Modes of death; EUROPEAN-SOCIETY; ECHOCARDIOGRAPHY; ASSOCIATION; AMYLOIDOSIS; CARDIOLOGY; DIAGNOSIS; MORTALITY; INSIGHTS; TIME;
D O I
10.1016/j.ijcard.2016.11.154
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Recent studies suggest that reduced right ventricular function is an important predictor of outcome in patients with heart failure and preserved ejection fraction (HFpEF). Because affected patients suffer from a broad spectrumof non-cardiac co-morbidities, it remains unclear, whether they actually die from right heart failure (RHF) or as a consequence of other conditions. Methods: Consecutive patients with a confirmed diagnosis of HFpEF were enrolled in this prospective registry. Local and external medical records, as well as telephone interviews with relatives were used to ascertain modes of death. RHF was accepted as a mode of death, if the following criteria were met: 1. right ventricular dysfunction assessed by transthoracic echocardiography, and 2. clinical signs of right heart decompensation at the time of death. Results: Out of 230 patients with complete follow-up, 16.5% (n = 38) died after a mean of 30 +/- 17months. 60.5% deaths were classified as cardiovascular and 34.2% as non-cardiovascular. In 5.3% patients, the reason for death remained unknown. Of the cardiovascular cases (n = 23), 91.4% of deaths were attributed to RHF, 4.3% died from stroke and 4.3% from sudden cardiac death. Of the non-cardiovascular deaths (n = 13), 46.2% of deaths were attributed to major infections and 38.4% deaths were related to cancer. Other reasons for death included ileus (7.7%) and major bleeding (7.7%). Conclusion: In our well-characterised HFpEF cohort, more than half of all deaths could directly be attributed to RHF. The right ventricle seems to be a meaningful therapeutic target in a subset of patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:422 / 426
页数:5
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