The prognostic value of altitude in patients with heart failure with reduced ejection fraction

被引:6
作者
Kaya, Ahmet [1 ]
Bayramoglu, Adil [1 ]
Bektas, Osman [1 ]
Yaman, Mehmet [1 ]
Gunaydin, Zeki Yuksel [1 ]
Topcu, Selim [2 ]
Gulcu, Oktay [3 ]
Aksu, Ugur [3 ]
Kalkan, Kamuran [3 ]
Tanboga, Ibrahim Halil [4 ]
机构
[1] Ordu Univ, Fac Med, Dept Cardiol, TR-50200 Ordu, Turkey
[2] Ataturk Univ, Fac Med, Dept Cardiol, Erzurum, Turkey
[3] Erzurum Training & Res Hosp, Dept Cardiol, Erzurum, Turkey
[4] Hisar Intercontinental Hosp, Dept Cardiol, Istanbul, Turkey
关键词
heart failure; altitude; cardiovascular outcome; CARDIAC-OUTPUT; ESC GUIDELINES; EXERCISE; DISEASE; EXPOSURE; STROKE; ADAPTATION; DIAGNOSIS; PRESSURE; HYPOXIA;
D O I
10.14744/AnatolJCardiol.2019.81535
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: It is well known that the altitude may affect the cardiovascular system. However, there were a few data related to the effect of altitude on the adverse outcome in patients with heart failure with reduced ejection fraction (HFREF). The aim of the present study was to investigate the role of intermediate high altitude on the major adverse cardiovascular outcome in patients with HFREF. Methods: Patients with HFREF admitted to the outpatient clinics at the first center at sea level and the second center at 1890 m were prospectively enrolled in the study. HFREF was defined as symptoms/signs of heart failure and left ventricular ejection fraction <40%. The major adverse cardiac outcome (MACE) was defined as all-cause death, stroke, and re-hospitalization due to heart failure. The median follow-up period of the study population was 27 months. Results: The study included 320 (58.55% male, mean age 65.7 +/- 11.2 years) patients. The incidence of all-cause death was 8.5%, stroke 6.1%, rehospitalization due to decompensated heart failure 34.3%, and MACE 48.9%. In Kaplan-Meier analysis, patients with HFREF living at high altitude had more MACE (71.1% vs. 25.3%, log rank p=0.005) and presented with more stroke (11.3% vs. 2.1%, log rank p=0.001) and re-hospitalization due to heart failure (65.1% vs. 20.1%, log rank p<0.001) rates than those at low altitude in the follow-up; however, the rate of all-cause death was similar (9.4% vs. 8.1%, log rank p=0.245). Conclusion: In the present study, we demonstrated that the intermediate high altitude is the independent predictor of MACE in patients with HFREF. High altitude may be considered as a risk factor in decompensating heart failure.
引用
收藏
页码:300 / 308
页数:9
相关论文
共 30 条
  • [1] Chronic kidney disease, anemia, and incident stroke in a middle-aged, community-based population: The ARIC Study
    Abramson, JL
    Jurkovitz, CT
    Vaccarino, V
    Weintraub, WS
    McClellan, W
    [J]. KIDNEY INTERNATIONAL, 2003, 64 (02) : 610 - 615
  • [2] Effects of simulated altitude-induced hypoxia on exercise capacity in patients with chronic heart failure
    Agostoni, P
    Cattadori, G
    Guazzi, M
    Bussotti, M
    Conca, C
    Lomanto, M
    Marenzi, G
    Guazzi, MD
    [J]. AMERICAN JOURNAL OF MEDICINE, 2000, 109 (06) : 450 - 455
  • [3] REDUCTION OF STROKE VOLUME DURING EXERCISE IN MAN FOLLOWING ASCENT TO 3100 M ALTITUDE
    ALEXANDER, JK
    HARTLEY, LH
    MODELSKI, M
    GROVER, RF
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1967, 23 (06) : 849 - +
  • [4] Impact of acute hypoxic pulmonary hypertension on LV diastolic function in healthy mountaineers at high altitude
    Allemann, Y
    Rotter, M
    Hutter, D
    Lipp, E
    Sartori, C
    Scherrer, U
    Seiler, C
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 2004, 286 (03): : H856 - H862
  • [5] Role of the autonomic nervous system in the reduced maximal cardiac output at altitude
    Bogaard, HJ
    Hopkins, SR
    Yamaya, Y
    Niizeki, K
    Ziegler, MG
    Wagner, PD
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 2002, 93 (01) : 271 - 279
  • [6] CATECHOLAMINES IN PLASMA AND URINE AT HIGH ALTITUDE
    CUNNINGHAM, WL
    BECKER, EJ
    KREUZER, F
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1965, 20 (04) : 607 - +
  • [7] CEREBRAL VENOUS THROMBOSIS DUE TO HIGH-ALTITUDE POLYCYTHEMIA
    FUJIMAKI, T
    MATSUTANI, M
    ASAI, A
    KOHNO, T
    KOIKE, M
    [J]. JOURNAL OF NEUROSURGERY, 1986, 64 (01) : 148 - 150
  • [8] SUBNORMAL CARDIAC OUTPUT AT REST AND DURING EXERCISE IN RESIDENTS AT 3100 M ALTITUDE
    HARTLEY, LH
    ALEXANDER, JK
    MODELSKI, M
    GROVER, RF
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1967, 23 (06) : 839 - +
  • [9] Hilton R, 1925, J Physiol, V59, P413
  • [10] Does intermediate high-altitude level affect major cardiovascular outcomes of patients acute myocardial infarction treated by primary coronary angioplasty? Preliminary results of observational study
    Isik, Turgay
    Ayhan, Erkan
    Tanboga, Ibrahim Halil
    [J]. ANADOLU KARDIYOLOJI DERGISI-THE ANATOLIAN JOURNAL OF CARDIOLOGY, 2012, 12 (07): : 611 - 611