Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure
Aims: We investigated whether addition of diastolic dysfunction (DD) and longitudinal strain (LS) to Stage B heart failure (SBHF) criteria (structural or systolic abnormality) improves prediction of symptomatic HF in participants of the SCReening Evaluation of the Evolution of New Heart Failure stud...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
WILEY PERIODICALS, INC
2019
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1044619 http://hdl.handle.net/20.500.11937/80069 |
| _version_ | 1848764154729463808 |
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| author | Coller, J.M. Gong, F.F. McGrady, M. Jelinek, M.V. Castro, J.M. Boffa, U. Shiel, L. Liew, D. Stewart, S. Krum, H. Reid, Christopher Prior, D.L. Campbell, D.J. |
| author_facet | Coller, J.M. Gong, F.F. McGrady, M. Jelinek, M.V. Castro, J.M. Boffa, U. Shiel, L. Liew, D. Stewart, S. Krum, H. Reid, Christopher Prior, D.L. Campbell, D.J. |
| author_sort | Coller, J.M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Aims: We investigated whether addition of diastolic dysfunction (DD) and longitudinal strain (LS) to Stage B heart failure (SBHF) criteria (structural or systolic abnormality) improves prediction of symptomatic HF in participants of the SCReening Evaluation of the Evolution of New Heart Failure study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Both American Society of Echocardiography and European Association of Cardiovascular Imaging (ASE/EACVI) criteria and age-specific Atherosclerosis Risk in Communities (ARIC) study criteria, for SBHF and DD, and ARIC criteria for abnormal LS, were examined.
Methods and results: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known HF, or ejection fraction <50% or >mild valve abnormality detected on previous echocardiography or other imaging. Echocardiography was performed in 3190 participants who were followed for a median of 3.9 (interquartile range: 3.4, 4.5) years after echocardiography. Symptomatic HF was diagnosed in 139 participants at a median of 3.1 (interquartile range: 2.1, 3.9) years after echocardiography. ARIC structural, systolic, and diastolic abnormalities predicted HF in univariate and multivariable proportional hazards analyses, whereas ASE/EACVI structural and systolic, but not diastolic, abnormalities predicted HF. ARIC and ASE/EACVI SBHF criteria predicted HF with sensitivities of 81% and 55%, specificities of 39% and 76%, and C statistics of 0.60 (95% confidence interval: 0.57, 0.64) and 0.66 (0.61, 0.71), respectively. Adding ARIC DD to SBHF increased sensitivity to 94% with specificity of 24% and C statistic of 0.59 (0.57, 0.61), whereas addition of ASE/EACVI DD to SBHF increased sensitivity to 97% but reduced specificity to 9% and the C statistic to 0.52 (0.50, 0.54, P < 0.0001). Addition of LS to ARIC or ASE/EACVI SBHF criteria had minimal impact on prediction of HF.
Conclusions: Age-specific ARIC DD criteria, but not ASE/EACVI DD criteria, predicted symptomatic HF, and addition of age-specific ARIC DD criteria to ARIC SBHF criteria improved prediction of symptomatic HF in asymptomatic individuals with cardiovascular disease risk factors. Addition of LS to ASE/EACVI or ARIC SBHF criteria did not improve prediction of symptomatic HF. |
| first_indexed | 2025-11-14T11:14:51Z |
| format | Journal Article |
| id | curtin-20.500.11937-80069 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:14:51Z |
| publishDate | 2019 |
| publisher | WILEY PERIODICALS, INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-800692023-04-12T08:08:57Z Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure Coller, J.M. Gong, F.F. McGrady, M. Jelinek, M.V. Castro, J.M. Boffa, U. Shiel, L. Liew, D. Stewart, S. Krum, H. Reid, Christopher Prior, D.L. Campbell, D.J. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Stage B Echocardiography Diastolic dysfunction Longitudinal strain LEFT-VENTRICULAR MASS EUROPEAN-ASSOCIATION AMERICAN-SOCIETY TASK-FORCE CHAMBER QUANTIFICATION ECHOCARDIOGRAPHY RECOMMENDATIONS ADULTS GUIDELINES RISK Aims: We investigated whether addition of diastolic dysfunction (DD) and longitudinal strain (LS) to Stage B heart failure (SBHF) criteria (structural or systolic abnormality) improves prediction of symptomatic HF in participants of the SCReening Evaluation of the Evolution of New Heart Failure study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. Both American Society of Echocardiography and European Association of Cardiovascular Imaging (ASE/EACVI) criteria and age-specific Atherosclerosis Risk in Communities (ARIC) study criteria, for SBHF and DD, and ARIC criteria for abnormal LS, were examined. Methods and results: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years. Exclusion criteria were known HF, or ejection fraction <50% or >mild valve abnormality detected on previous echocardiography or other imaging. Echocardiography was performed in 3190 participants who were followed for a median of 3.9 (interquartile range: 3.4, 4.5) years after echocardiography. Symptomatic HF was diagnosed in 139 participants at a median of 3.1 (interquartile range: 2.1, 3.9) years after echocardiography. ARIC structural, systolic, and diastolic abnormalities predicted HF in univariate and multivariable proportional hazards analyses, whereas ASE/EACVI structural and systolic, but not diastolic, abnormalities predicted HF. ARIC and ASE/EACVI SBHF criteria predicted HF with sensitivities of 81% and 55%, specificities of 39% and 76%, and C statistics of 0.60 (95% confidence interval: 0.57, 0.64) and 0.66 (0.61, 0.71), respectively. Adding ARIC DD to SBHF increased sensitivity to 94% with specificity of 24% and C statistic of 0.59 (0.57, 0.61), whereas addition of ASE/EACVI DD to SBHF increased sensitivity to 97% but reduced specificity to 9% and the C statistic to 0.52 (0.50, 0.54, P < 0.0001). Addition of LS to ARIC or ASE/EACVI SBHF criteria had minimal impact on prediction of HF. Conclusions: Age-specific ARIC DD criteria, but not ASE/EACVI DD criteria, predicted symptomatic HF, and addition of age-specific ARIC DD criteria to ARIC SBHF criteria improved prediction of symptomatic HF in asymptomatic individuals with cardiovascular disease risk factors. Addition of LS to ASE/EACVI or ARIC SBHF criteria did not improve prediction of symptomatic HF. 2019 Journal Article http://hdl.handle.net/20.500.11937/80069 10.1002/ehf2.12449 English http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1092642 http://purl.org/au-research/grants/nhmrc/1136372 http://purl.org/au-research/grants/nhmrc/1045862 http://purl.org/au-research/grants/nhmrc/1041796 http://purl.org/au-research/grants/nhmrc/559010 http://purl.org/au-research/grants/nhmrc/395508 http://purl.org/au-research/grants/nhmrc/620241 http://purl.org/au-research/grants/nhmrc/519456 WILEY PERIODICALS, INC fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Stage B Echocardiography Diastolic dysfunction Longitudinal strain LEFT-VENTRICULAR MASS EUROPEAN-ASSOCIATION AMERICAN-SOCIETY TASK-FORCE CHAMBER QUANTIFICATION ECHOCARDIOGRAPHY RECOMMENDATIONS ADULTS GUIDELINES RISK Coller, J.M. Gong, F.F. McGrady, M. Jelinek, M.V. Castro, J.M. Boffa, U. Shiel, L. Liew, D. Stewart, S. Krum, H. Reid, Christopher Prior, D.L. Campbell, D.J. Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title | Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title_full | Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title_fullStr | Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title_full_unstemmed | Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title_short | Age-specific diastolic dysfunction improves prediction of symptomatic heart failure by Stage B heart failure |
| title_sort | age-specific diastolic dysfunction improves prediction of symptomatic heart failure by stage b heart failure |
| topic | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Heart failure Stage B Echocardiography Diastolic dysfunction Longitudinal strain LEFT-VENTRICULAR MASS EUROPEAN-ASSOCIATION AMERICAN-SOCIETY TASK-FORCE CHAMBER QUANTIFICATION ECHOCARDIOGRAPHY RECOMMENDATIONS ADULTS GUIDELINES RISK |
| url | http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://purl.org/au-research/grants/nhmrc/1044619 http://hdl.handle.net/20.500.11937/80069 |