Maintenance haemodialysis patients with HFpEF had a significantly higher risk of all-cause mortality compared to those without heart failure (HR 2.47; 95% CI 1.55-3.91; P < 0.0001).
Cohort (n=439)
In maintenance hemodialysis patients, HFpEF is highly prevalent, associated with poor long-term survival, and can be predicted by an NT-proBNP cut-off of 4922.5 pg/mL.
Effect estimate: HR 2.47 (95% CI 1.55-3.91)
p-value: p=< 0.0001
AIMS: Heart failure (HF) is a common complication and the leading cause of mortality in maintenance haemodialysis (MHD) patients. Few studies have investigated heart failure with preserved ejection fraction (HFpEF), which is known to affect a majority of patients. The objective of this study is to explore the prevalence, clinical profiles, diagnosis, risk factors and prognosis of MHD patients with HFpEF. METHODS AND RESULTS: Four hundred thirty-nine patients haemodialyzsed for over 3 months were enrolled in the study and evaluated for HF according to the European Society of Cardiology guidelines. Clinical and laboratory parameters were recorded at baseline. The median follow-up of the study was 22.5 months. A total of 111 (25.3%) MHD patients were diagnosed with HF, while 94 (84.7%) of the HF patients were classified into HFpEF. The cut-off value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 4922.5 pg/mL for predicting HFpEF (sensitivity 0.840, specificity 0.723, AUC 0.866) in MHD patients. Age, diabetes mellitus, coronary artery disease and serum phosphorus were independent risk factors for the incidence of HFpEF in MHD patients while normal urine volume, haemoglobin, serum iron and serum sodium were protective factors. MHD patients with HFpEF had a higher risk of all-cause mortality than those without HF (hazard ratio 2.47, 95% confidence interval 1.55-3.91, P < 0.0001). CONCLUSIONS: The majority of MHD patients with HF were categorized into HFpEF, with a poor long-term survival rate. NT-proBNP beyond 4922.5 pg/mL performed well in the prediction of HFpEF in MHD patients.
Yu et al. (Sun,) conducted a cohort in Heart Failure with Preserved Ejection Fraction in Haemodialysis Patients (n=439). Heart failure with preserved ejection fraction (HFpEF) vs. No heart failure was evaluated on All-cause mortality (HR 2.47, 95% CI 1.55-3.91, p=< 0.0001). Maintenance haemodialysis patients with HFpEF had a significantly higher risk of all-cause mortality compared to those without heart failure (HR 2.47; 95% CI 1.55-3.91; P < 0.0001).