Cited by 517Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementCardiac Fibrosis and Remodeling

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Prevalence and Significance of Alterations in Cardiac Structure and Function in Patients With Heart Failure and a Preserved Ejection Fraction

Zile, Michael R., Gottdiener, John S., Hetzel, Scott J., McMurray, John J., Komajda, Michel, McKelvie, Robert, Baicu, Catalin F., Massie, Barry M., Carson, Peter E.·2011·Circulation

DOI 10.1161/circulationaha.110.011031

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Abstract

Background—: The purpose of this study was to examine the prevalence of abnormalities in cardiac structure and function present in patients with heart failure and a preserved ejection fraction (HFPEF) and to determine whether these alterations in structure and function were associated with cardiovascular morbidity and mortality. Methods and Results—: The Irbesartan in HFPEF trial (I-PRESERVE) enrolled 4128 patients; echocardiographic determination of left ventricular (LV) volume, mass, left atrial (LA) size, systolic function, and diastolic function were made at baseline in 745 patients. The primary end point was death or protocol-specific cardiovascular hospitalization. A secondary end point was the composite of heart failure death or heart failure hospitalization. Associations between baseline structure and function and patient outcomes were examined using univariate and multivariable Cox proportional hazard analyses. In this substudy, LV hypertrophy or concentric remodeling was present in 59%, LA enlargement was present in 66%, and diastolic dysfunction was present in 69% of the patients. Multivariable analyses controlling for 7 clinical variables (including log N-terminal pro-B–type natriuretic peptide) indicated that increased LV mass, mass/volume ratio, and LA size were independently associated with an increased risk of both primary and heart failure events (all P <0.05). Conclusions—: Left ventricular hypertrophy or concentric remodeling, LA enlargement, and diastolic dysfunction were present in the majority of patients with HFPEF. Left ventricular mass and LA size were independently associated with an increased risk of morbidity and mortality. The presence of structural remodeling and diastolic dysfunction may be useful additions to diagnostic criteria and provide important prognostic insights in patients with HFPEF. Clinical Trial Registration—: http://www.clinicaltrials.gov . Unique identifier: NCT00095238.

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Authors: Zile, M. R., Gottdiener, J. S., Hetzel, S. J., McMurray, J. J., Komajda, M., McKelvie, R., Baicu, C. F., Massie, B. M., & Carson, P. E.
Affiliations: University of Maryland Medical Center (US)
From the RHJ Department of Veterans Affairs Medical Center and Medical University of South Carolina, Charleston, SC (M.R.Z., C.F.B.); University of Maryland Medical Center, Baltimore, MD (J.S.G.); University of Wisconsin School of Medicine and Public Health, Madison, WI (S.J.H.); British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK (J.J.M.); Université Paris 6; Pitié Salpêtrière Hospital, Paris, France (M.K.); Hamilton Health Sciences, McMaster...
ORCID: Zile, Michael R.
Gottdiener, John S.
Hetzel, Scott J.
McMurray, John J.
McKelvie, Robert
Baicu, Catalin F.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-12-06
Volume: 124
Issue: 23
Pages: 2491-2501
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.110.011031
OpenAlex: W2149841172
Cited by: 517
References: 41
Citations by year: 2026: 18 · 2025: 28 · 2024: 26 · 2023: 24 · 2022: 45 · 2021: 42 · 2020: 37 · 2019: 41 · 2018: 32 · 2017: 36 · 2016: 48 · 2015: 29 · 2014: 47 · 2013: 41 · 2012: 21
FWCI: 23.80
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
Research Bank (Australian Catholic University) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords: heart failure with preserved ejection fraction, left ventricular hypertrophy, concentric remodeling, left atrial enlargement, diastolic dysfunction, left ventricular mass, left ventricular volume, cardiovascular morbidity and mortality, heart failure hospitalization, irbesartan, prognostic factors, N-terminal pro-brain natriuretic peptide
MeSH terms: Irbesartan, Aged, Biphenyl Compounds, Diastole, Echocardiography, Female, Heart Failure, Heart Ventricles, Humans, Male, Morbidity, Prognosis, Risk Factors, Stroke Volume, Systole, Tetrazoles, Echocardiography, Doppler, Cohort Studies, Prevalence, Ventricular Remodeling, Angiotensin II Type 1 Receptor Blockers

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Prevalence and Significance of Alterations in Cardiac Structure and Function in Patients With Heart Failure and a Preserved Ejection Fraction

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