TY - JOUR
T1 - Incidence of Preclinical Heart Failure in a Community Population
AU - Young, Kathleen A.
AU - Scott, Christopher G.
AU - Rodeheffer, Richard J.
AU - Chen, Horng H.
N1 - Publisher Copyright:
© 2022 The Authors.
PY - 2022/8/2
Y1 - 2022/8/2
N2 - BACKGROUND: A high prevalence of preclinical heart failure (HF) (Stages A and B) has previously been shown. The aim of this study was to explore factors associated with the incidence of preclinical HF in a community population. METHODS AND RESULTS: Retrospective review of 393 healthy community individuals aged ≥45 years from the Olmsted County Heart Function Study that returned for 2 visits, 4 years apart. At visit 2, individuals that remained normal were compared with those that developed preclinical HF. By the second visit, 191 (49%) developed preclinical HF (12.1 cases per 100 person-years of follow-up); 65 (34%) Stage A and 126 (66%) Stage B. Those that developed preclinical HF (n=191) were older (P=0.004), had a higher body mass index (P<0.001), and increased left ventricular mass index (P=0.006). When evaluated separately, increased body mass index was seen with development of Stage A (P<0.001) or Stage B (P=0.009). Echocardiographic mark-ers of diastolic function were statistically different in those that developed Stage A [higher E/e’ (P<0.001), lower e’ (P<0.001)] and Stage B [higher left atrial volume index (P<0.001), higher E/e’ (P<0.001), lower e’ (P<0.001)]. NT-proBNP (N-terminal pro-B-type natriuretic peptide) was higher at visit 2 in those that developed Stage A or B (P<0.001 for both). Hypertension (57%), obesity (34%), and hyperlipidemia (25%) were common in the development of Stage A. Of patients who developed Stage B, 71% (n=84) had moderate or severe diastolic dysfunction. CONCLUSIONS: There is a high incidence of preclinical HF in a community population. Development of Stage A was driven by hypertension and obesity, while preclinical diastolic dysfunction was seen commonly in those that developed Stage B.
AB - BACKGROUND: A high prevalence of preclinical heart failure (HF) (Stages A and B) has previously been shown. The aim of this study was to explore factors associated with the incidence of preclinical HF in a community population. METHODS AND RESULTS: Retrospective review of 393 healthy community individuals aged ≥45 years from the Olmsted County Heart Function Study that returned for 2 visits, 4 years apart. At visit 2, individuals that remained normal were compared with those that developed preclinical HF. By the second visit, 191 (49%) developed preclinical HF (12.1 cases per 100 person-years of follow-up); 65 (34%) Stage A and 126 (66%) Stage B. Those that developed preclinical HF (n=191) were older (P=0.004), had a higher body mass index (P<0.001), and increased left ventricular mass index (P=0.006). When evaluated separately, increased body mass index was seen with development of Stage A (P<0.001) or Stage B (P=0.009). Echocardiographic mark-ers of diastolic function were statistically different in those that developed Stage A [higher E/e’ (P<0.001), lower e’ (P<0.001)] and Stage B [higher left atrial volume index (P<0.001), higher E/e’ (P<0.001), lower e’ (P<0.001)]. NT-proBNP (N-terminal pro-B-type natriuretic peptide) was higher at visit 2 in those that developed Stage A or B (P<0.001 for both). Hypertension (57%), obesity (34%), and hyperlipidemia (25%) were common in the development of Stage A. Of patients who developed Stage B, 71% (n=84) had moderate or severe diastolic dysfunction. CONCLUSIONS: There is a high incidence of preclinical HF in a community population. Development of Stage A was driven by hypertension and obesity, while preclinical diastolic dysfunction was seen commonly in those that developed Stage B.
KW - incidence
KW - natural history
KW - preclinical heart failure
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U2 - 10.1161/JAHA.122.025519
DO - 10.1161/JAHA.122.025519
M3 - Article
C2 - 35862175
AN - SCOPUS:85135213170
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 15
M1 - e025519
ER -