Cardiac Dysfunction and Noncardiac Dysfunction as Precursors of Heart Failure With Reduced and Preserved Ejection Fraction in the Community
Key result
Antecedent LV systolic dysfunction is linked to ~133% higher risk of incident HF.
- HR 2.33
- 95% CI 1.43-3.78
- n=1,038
Why the study?
Longitudinal data demonstrating that asymptomatic cardiac dysfunction precedes overt HF are scarce, and the contribution of noncardiac dysfunction to HF progression is unclear.
Does subclinical cardiac and noncardiac organ dysfunction increase the risk of incident heart failure in a community-based cohort?
Population
1038 participants of the Framingham Heart Study original cohort, mean age 76±5 years, 39% men
Comparison
Presence vs absence of subclinical cardiac and noncardiac organ dysfunction
Design
Cohort study
Follow-up
Mean 11 years
Authors
Discussion
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Member takes
Implication
May support subclinical dysfunction assessment for HF risk stratification; hypothesis-generating for multiorgan prevention trials.
Study Design
Type
Cohort (n=1,038)
Structured PICO
Does subclinical cardiac and noncardiac organ dysfunction increase the risk of incident heart failure in a community-based cohort?
P
Population
1,038 participants of the Framingham Heart Study original cohort (mean age 76, 61% female) followed for a mean of 11 years to assess incident heart failure.
E
Exposure
Presence of subclinical cardiac dysfunction (left ventricular systolic and diastolic) and noncardiac organ dysfunction (renal, pulmonary, hematologic).
C
Comparator
Absence of subclinical cardiac and noncardiac organ dysfunction.
O
Outcome
Incident heart failure events.hard clinical
Main Result
Hazard Ratio: 2.33 (95% CI 1.43–3.78)
Antecedent subclinical cardiac and noncardiac organ dysfunction independently predict the development of incident heart failure, highlighting HF as a progressive, multiorgan syndrome.
Cite This Study
Lam et al. (2011) conducted a cohort in Heart failure (n=1,038). Antecedent cardiac and noncardiac organ dysfunction vs. Absence of dysfunction was evaluated on Incident HF events (HR 2.33, 95% CI 1.43-3.78). Antecedent left ventricular systolic dysfunction (HR 2.33; 95% CI 1.43-3.78) and subclinical noncardiac organ dysfunction were associated with an increased risk of incident heart failure.