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1. Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial

Author

Wei, Fang-Fei, Pellicori, Pierpaolo, Ferreira, João Pedro, González, Arantxa, Mariottoni, Beatrice, An, De-Wei, Verdonschot, Job A. J., Liu, Chen, Ahmed, Fozia Z., Petutschnigg, Johannes, Rossignol, Patrick, Heymans, Stephane, Cuthbert, Joe, Girerd, Nicolas, Clark, Andrew L., Li, Yan, Nawrot, Tim S., Díez, Javier, Zannad, Faiez, Cleland, John G. F., and Staessen, Jan A.

Published
2024
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2. An outcome-driven threshold for pulse pressure amplification

Author

Huang, Qi-Fang, An, De-Wei, Aparicio, Lucas S., Cheng, Yi-Bang, Wei, Fang-Fei, Yu, Yu-Ling, Sheng, Chang-Sheng, Yang, Wen-Yi, Niiranen, Teemu J., Boggia, José, Stolarz-Skrzypek, Katarzyna, Tikhonoff, Valérie, Gilis-Malinowska, Natasza, Wojciechowska, Wiktoria, Casiglia, Edoardo, Narkiewicz, Krzysztof, Filipovský, Jan, Kawecka-Jaszcz, Kalina, Nawrot, Tim S., Wang, Ji-Guang, Li, Yan, and Staessen, Jan A.

Published
2024
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6. Association of Air Pollution with a Urinary Biomarker of Biological Aging and Effect Modification by Vitamin K in the FLEMENGHO Prospective Population Study

Author

Martens, Dries S., An, De-Wei, Yu, Yu-Ling, Chori, Babangida S., Wang, Congrong, Silva, Ana Ines, Wei, Fang-Fei, Liu, Chen, Stolarz-Skrzypek, Katarzyna, Rajzer, Marek, Latosinska, Agnieszka, Mischak, Harald, Staessen, Jan A., and Nawrot, Tim S.

Subjects
Urine -- Analysis, Medical research, Medicine, Experimental, Aging -- Health aspects, Environmentally induced diseases -- Risk factors -- Statistics, Vitamin K -- Health aspects, Air pollution -- Health aspects -- Statistics, Biological markers -- Research, Particles -- Health aspects -- Statistics, Environmental issues, Health
Abstract

BACKGROUND: A recently developed urinary peptidomics biological aging clock can be used to study accelerated human aging. From 1990 to 2019, exposure to airborne particulate matter (PM) became the leading environmental risk factor worldwide. OBJECTIVES: This study investigated whether air pollution exposure is associated with accelerated urinary peptidomic aging, independent of calendar age, and whether this association is modified by other risk factors. METHODS: In a Flemish population, the urinary peptidomic profile (UPP) age (UPP-age) was derived from the urinary peptidomic profile measured by capillary electrophoresis coupled with mass spectrometry. UPP-age-R was calculated as the residual of the regression of UPP-age on chronological age, which reflects accelerated aging predicted by UPP-age, independent of chronological age. A high-resolution spatial-temporal interpolation method was used to assess each individual's exposure to P[M.sub.10], P[M.sub.2.5], black carbon (BC), and nitrogen dioxide (N[O.sub.2]). Associations of UPP-age-R with these pollutants were investigated by mixed models, accounting for clustering by residential address and confounders. Effect modifiers of the associations between UPP-age-R and air pollutants that included 18 factors reflecting vascular function, renal function, insulin resistance, lipid metabolism, or inflammation were evaluated. Direct and indirect (via UPP-age-R) effects of air pollution on mortality were evaluated by multivariable-adjusted Cox models. RESULTS: Among 660 participants (50.2% women; mean age: 50.7 y), higher exposure to P[M.sub.10], P[M.sub.2.5], BC, and N[O.sub.2] was associated with a higher UPP-age-R. Studying effect modifiers showed that higher plasma levels of desphospho-uncarboxylated matrix Gla protein (dpucMGP), signifying poorer vitamin K status, steepened the slopes of UPP-age-R on the air pollutants. In further analyses among participants with dpucMGP [greater than or equal to] 4.26 [micro]g/L (median), an interquartile range (IQR) higher level in P[M.sub.10], P[M.sub.2.5], BC, and N[O.sub.2] was associated with a higher UPP-age-R of 2.03 [95% confidence interval (CI): 0.60, 3.46], 2.22 (95% CI: 0.71, 3.74), 2.00 (95% CI: 0.56, 3.43), and 2.09 (95% CI: 0.77, 3.41) y, respectively. UPP-age-R was an indirect mediator of the associations of mortality with the air pollutants [multivariable-adjusted hazard ratios from 1.094 (95% CI: 1.000, 1.196) to 1.110 (95% CI: 1.007, 1.224)] in participants with a high dpucMGP, whereas no direct associations were observed. DISCUSSION: Ambient air pollution was associated with accelerated urinary peptidomics aging, and high vitamin K status showed a potential protective effect in this population. Current guidelines are insufficient to decrease the adverse health effects of airborne pollutants, including healthy aging trajectories. https://doi.org/10.1289/EHP13414, Introduction Over the past 20 y, global life expectancy at birth increased from 67.2 to 73.5 y. (1) In line with this remarkable increase in longevity, global exposure to harmful [...]

Published
2023
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18. Mortality and Cardiovascular End Points In Relation to the Aortic Pulse Wave Components: An Individual-Participant Meta-Analysis.

Author

Norton, Gavin R., An, De-Wei, Aparicio, Lucas S., Yu, Yu-Ling, Wei, Fang-Fei, Niiranen, Teemu J., Liu, Chen, Stolarz-Skrzypek, Katarzyna, Wojciechowska, Wiktoria, Jula, Antti M., Rajzer, Marek, Martens, Dries S., Verhamme, Peter, Li, Yan, Kawecka-Jaszcz, Kalina, Nawrot, Tim S., Staessen, Jan A., and Woodiwiss, Angela J.

Abstract

BACKGROUND: Wave separation analysis enables individualized evaluation of the aortic pulse wave components. Previous studies focused on the pressure height with overall positive but differing results. In the present analysis, we assessed the associations of the pressure of forward and backward (Pfor and Pref) pulse waves with prospective cardiovascular end points, with extended analysis for time to pressure peak (Tfor and Tref). METHODS: Participants in 3 IDCARS (International Database of Central Arterial Properties for Risk Stratification) cohorts (Argentina, Belgium, and Finland) aged ≥20 years with valid pulse wave analysis and follow-up data were included. Pulse wave analysis was done using the SphygmoCor device, and pulse wave separation was done using the triangular method. The primary end points consisted of cardiovascular mortality and nonfatal cardiovascular and cerebrovascular events. Multivariable-adjusted Cox regression was used to calculate hazard ratios. RESULTS: A total of 2206 participants (mean age, 57.0 years; 55.0% women) were analyzed. Mean±SDs for Pfor, Pref, Tfor, and Tfor/Tref were 31.0±9.1 mm Hg, 20.8±8.4 mm Hg, 130.8±35.5, and 0.51±0.11, respectively. Over a median follow-up of 4.4 years, 146 (6.6%) participants experienced a primary end point. Every 1 SD increment in Pfor, Tfor, and Tfor/Tref was associated with 27% (95% CI, 1.07–1.49), 25% (95% CI, 1.07–1.45), and 32% (95% CI, 1.12–1.56) higher risk, respectively. Adding Tfor and Tfor/Tref to existing risk models improved model prediction (∆Uno's C, 0.020; P <0.01). CONCLUSIONS: Pulse wave components were predictive of composite cardiovascular end points, with Tfor/Tref showing significant improvement in risk prediction. Pending further confirmation, the ratio of time to forward and backward pressure peak may be useful to evaluate increased afterload and signify increased cardiovascular risk. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Prognostic Significance of Blood Pressure at Rest and After Performing the Six-Minute Walk Test in Patients With Acute Heart Failure.

Author

Huang, Jiale, Yu, Zhongping, Wu, Yuzhong, He, Xin, Zhao, Jingjing, He, Jiangui, Staessen, Jan A, Dong, Yugang, Liu, Chen, and Wei, Fang-Fei

Subjects
HEART failure patients, BLOOD pressure, ACUTE kidney failure, KIDNEY diseases, COOLDOWN
Abstract

BACKGROUND It remains unclear whether systolic (SBP) and diastolic (DBP) pressure and BP response after six-minute walk test (6MWT) are associated with adverse outcomes in patients with acute heart failure (AHF). METHODS We investigated these associations in 98 AHF patients (24.5% women; mean age, 70.5 years) enrolled in the ROSE trial (The Low-dose Dopamine or Low-dose Nesiritide in Acute Heart Failure with Renal Dysfunction). The primary endpoint consisted of any death or rehospitalization within 6 months after randomization. We computed hazard ratios (HRs) of the risks associated with 1-SD increase in post-exercise BP levels and BP ratios, calculated as BP immediately after 6MWT divided by BP before 6MWT. RESULTS The BP before and after 6MWT averaged 110.6/117.5 mm Hg for SBP and 61.9/64.7 mm Hg for DBP. In multivariable-adjusted analyses including clinic BP measured at the same day of 6MWT, higher DBP after 6MWT was associated with lower risk of the primary endpoint (HR, 0.49; 95% confidence interval [CI], 0.26–0.95; P  = 0.034). Both higher SBP and DBP immediately after 6MWT were associated with lower risk of 6-month mortality (HRs, 0.39/0.16; 95% CI, 0.17–0.90/0.065–0.40; P  ≤ 0.026). The post-exercise SBP ratio was associated with the risk of 6-month mortality in multivariable-adjusted analyses (HR, 0.44; P  = 0.023). CONCLUSIONS Higher BP levels and BP ratios immediately after 6MWT conferred l ower risk of adverse health outcomes. Our observations highlight that 6MWT-related BP level and response may refine risk estimates in patients hospitalized AHF and may help further investigation for the development of HF preventive strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure

Author

Melgarejo, Jesus D., Yang, Wen-Yi, Thijs, Lutgarde, Li, Yan, Asayama, Kei, Hansen, Tine W., Wei, Fang-Fei, Kikuya, Masahiro, Ohkubo, Takayoshi, Dolan, Eamon, Stolarz-Skrzypek, Katarzyna, Huang, Qi-Fang, Tikhonoff, Valérie, Malyutina, Sofia, Casiglia, Edoardo, Lind, Lars, Sandoya, Edgardo, Filipovský, Jan, Gilis-Malinowska, Natasza, Narkiewicz, Krzysztof, Kawecka-Jaszcz, Kalina, Boggia, José, Wang, Ji-Guang, Imai, Yutaka, Vanassche, Thomas, Verhamme, Peter, Janssens, Stefan, O’Brien, Eoin, Maestre, Gladys E., Staessen, Jan A., and Zhang, Zhen-Yu

Published
2021
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28. Cardiovascular End Points and Mortality Are Not Closer Associated With Central Than Peripheral Pulsatile Blood Pressure Components

Author

Huang, Qi-Fang, Aparicio, Lucas S., Thijs, Lutgarde, Wei, Fang-Fei, Melgarejo, Jesus D., Cheng, Yi-Bang, Sheng, Chang-Sheng, Yang, Wen-Yi, Gilis-Malinowska, Natasza, Boggia, José, Niiranen, Teemu J., Wojciechowska, Wiktoria, Stolarz-Skrzypek, Katarzyna, Barochiner, Jessica, Ackermann, Daniel, Tikhonoff, Valérie, Ponte, Belen, Pruijm, Menno, Casiglia, Edoardo, Narkiewicz, Krzysztof, Filipovský, Jan, Czarnecka, Danuta, Kawecka-Jaszcz, Kalina, Jula, Antti M., Bochud, Murielle, Vanassche, Thomas, Verhamme, Peter, Struijker-Boudier, Harry A.J., Wang, Ji-Guang, Zhang, Zhen-Yu, Li, Yan, and Staessen, Jan A.

Published
2020
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29. Opposing Age-Related Trends in Absolute and Relative Risk of Adverse Health Outcomes Associated With Out-of-Office Blood Pressure

Author

Li, Yan, Thijs, Lutgarde, Zhang, Zhen-Yu, Asayama, Kei, Hansen, Tine W., Boggia, José, Björklund-Bodegård, Kristina, Yang, Wen-Yi, Niiranen, Teemu J., Ntineri, Angeliki, Wei, Fang-Fei, Kikuya, Masahiro, Ohkubo, Takayoshi, Dolan, Eamon, Hozawa, Atsushi, Tsuji, Ichiro, Stolarz-Skrzypek, Katarzyna, Huang, Qi-Fang, Melgarejo, Jesus D., Tikhonoff, Valérie, Malyutina, Sofia, Casiglia, Edoardo, Nikitin, Yuri, Lind, Lars, Sandoya, Edgardo, Aparicio, Lucas, Barochiner, Jessica, Gilis-Malinowska, Natasza, Narkiewicz, Krzysztof, Kawecka-Jaszcz, Kalina, Maestre, Gladys E., Jula, Antti M., Johansson, Jouni K., Kuznetsova, Tatiana, Filipovský, Jan, Stergiou, George, Wang, Ji-Guang, Imai, Yutaka, OʼBrien, Eoin, and Staessen, Jan A.

Published
2019
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30. Outcome-Driven Thresholds for Ambulatory Blood Pressure Based on the New American College of Cardiology/American Heart Association Classification of Hypertension

Author

Cheng, Yi-Bang, Thijs, Lutgarde, Zhang, Zhen-Yu, Kikuya, Masahiro, Yang, Wen-Yi, Melgarejo, Jesus D., Boggia, José, Wei, Fang-Fei, Hansen, Tine W., Yu, Cai-Guo, Asayama, Kei, Ohkubo, Takayoshi, Dolan, Eamon, Stolarz-Skrzypek, Katarzyna, Malyutina, Sofia, Casiglia, Edoardo, Lind, Lars, Filipovský, Jan, Maestre, Gladys E., Imai, Yutaka, Kawecka-Jaszcz, Kalina, Sandoya, Edgardo, Narkiewicz, Krzysztof, Li, Yan, O’Brien, Eoin, Wang, Ji-Guang, and Staessen, Jan A.

Published
2019
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32. Risk Stratification by Cross-Classification of Central and Brachial Systolic Blood Pressure

Author

Cheng, Yi-Bang, Thijs, Lutgarde, Aparicio, Lucas S., Huang, Qi-Fang, Wei, Fang-Fei, Yu, Yu-Ling, Barochiner, Jessica, Sheng, Chang-Sheng, Yang, Wen-Yi, Niiranen, Teemu J., Boggia, Jose, Zhang, Zhen-Yu, Stolarz-Skrzypek, Katarzyna, Gilis-Malinowska, Natasza, Tikhonoff, Valerie, Wojciechowska, Wiktoria, Casiglia, Edoardo, Narkiewicz, Krzysztof, Filipovsky, Jan, Kawecka-Jaszcz, Kalina, Wang, Ji-Guang, Li, Yan, and Staessen, Jan A.

Subjects
cardiovascular risk, Male, brachial blood pressure, hypertension, Brachial Artery, Physiology, central blood pressure, Blood Pressure, Blood Pressure Determination, Middle Aged, mortality, Risk Assessment, population science, Female, Humans, Hypertension, Internal Medicine, Cardiology and Cardiovascular Medicine
Abstract

Background: Whether cardiovascular risk is more tightly associated with central (cSBP) than brachial (bSBP) systolic pressure remains debated, because of their close correlation and uncertain thresholds to differentiate cSBP into normotension versus hypertension. Methods: In a person-level meta-analysis of the International Database of Central Arterial Properties for Risk Stratification (n=5576; 54.1% women; mean age 54.2 years), outcome-driven thresholds for cSBP were determined and whether the cross-classification of cSBP and bSBP improved risk stratification was explored. cSBP was tonometrically estimated from the radial pulse wave using SphygmoCor software. Results: Over 4.1 years (median), 255 composite cardiovascular end points occurred. In multivariable bootstrapped analyses, cSBP thresholds (in mm Hg) of 110.5 (95% CI, 109.1–111.8), 120.2 (119.4–121.0), 130.0 (129.6–130.3), and 149.5 (148.4–150.5) generated 5-year cardiovascular risks equivalent to the American College of Cardiology/American Heart Association bSBP thresholds of 120, 130, 140, and 160. Applying 120/130 mm Hg as cSBP/bSBP thresholds delineated concordant central and brachial normotension (43.1%) and hypertension (48.2%) versus isolated brachial hypertension (5.0%) and isolated central hypertension (3.7%). With concordant normotension as reference, the multivariable hazard ratios for the cardiovascular end point were 1.30 (95% CI, 0.58–2.94) for isolated brachial hypertension, 2.28 (1.21–4.30) for isolated central hypertension, and 2.02 (1.41–2.91) for concordant hypertension. The increased cardiovascular risk associated with isolated central and concordant hypertension was paralleled by cerebrovascular end points with hazard ratios of 3.71 (1.37–10.06) and 2.60 (1.35–5.00), respectively. Conclusions: Irrespective of the brachial blood pressure status, central hypertension increased cardiovascular and cerebrovascular risk indicating the importance of controlling central hypertension.

Published
2022

38. Additional file 1 of Association between epicardial adipose tissue and incident heart failure mediating by alteration of natriuretic peptide and myocardial strain

Author

Choy, Manting, Huang, Yuwen, Peng, Yang, Liang, Weihao, He, Xin, Chen, Chen, Li, Jiayong, Zhu, Wengen, Wei, Fang-fei, Dong, Yugang, Liu, Chen, and Wu, Yuzhong

Abstract

Additional file 1: Table S1. Detailed diagnostic criteria of study outcomes. Table S2. Baseline right ventricle indexes according to EAT thickness. Table S3. The differences of the shortlisted 14 circulating biomarkers according to EAT thickness. Table S4. The associations of all 85 circulating biomarkers with EAT thickness. Table S5. Baseline characteristics according to occurrence of incident heart failure and LVEF stratification in those with incident heart failure. Table S6. The hazard ratio of EAT and adjusted factors in univariate and multivariate models which assessed their association with incident heart failure. Table S7. Associations of circulating biomarkers and cardiac measures with incident heart failure. Table S8. Mediation analyses of circulating biomarkers and cardiac measures in the association of EAT with the risk of heart failure.

Published
2023
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43. Association of colorectal cancer with genetic and epigenetic variation in PEAR1-A population-based cohort study

Author

Yang, Wen-Yi, Izzi, Benedetta, Bress, Adam P., Thijs, Lutgarde, Citterio, Lorena, Wei, Fang-Fei, Salvi, Erika, Delli Carpini, Simona, Manunta, Paolo, Cusi, Daniele, Hoylaerts, Marc F., Luttun, Aernout, Verhamme, Peter, Hardikar, Sheetal, NAWROT, Tim, Staessen, Jan A., Zhang , Zhen-Yu, Mischak, Harald, Citterio, Lorena/0000-0001-6455-2291, Hoylaerts, Marc/0000-0002-6474-3933, Zhenyu/0000-0002-3785-7417, Cusi, Daniele/0000-0002-1006-7597, Yang, Wen-Yi, Izzi, Benedetta, Bress, Adam P, Thijs, Lutgarde, Citterio, Lorena, Wei, Fang-Fei, Salvi, Erika, Delli Carpini, Simona, Manunta, Paolo, Cusi, Daniele, Hoylaerts, Marc F, Luttun, Aernout, Verhamme, Peter, Hardikar, Sheetal, Nawrot, Tim S, Staessen, Jan A, and Zhang, Zhen-Yu

Subjects
Adult, Cohort Studies, Male, Multidisciplinary, Humans, Female, Genetic Predisposition to Disease, Receptors, Cell Surface, DNA Methylation, Colorectal Neoplasms, Epigenesis, Genetic
Abstract

Platelet Endothelial Aggregation Receptor 1 (PEAR1) modulates angiogenesis and platelet contact-induced activation, which play a role in the pathogenesis of colorectal cancer. We therefore tested the association of incident colorectal cancer and genetic and epigenetic variability in PEAR1 among 2532 randomly recruited participants enrolled in the family-based Flemish Study on Environment, Genes and Health Outcomes (51.2% women; mean age 44.8 years). All underwent genotyping of rs12566888 located in intron 1 of the PEAR1 gene; in 926 participants, methylation at 16 CpG sites in the PEAR1 promoter was also assessed. Over 18.1 years (median), 49 colorectal cancers occurred, all in different pedigrees. While accounting for clustering of risk factors within families and adjusting for sex, age, body mass index, the total-to-HDL cholesterol ratio, serum creatinine, plasma glucose, smoking and drinking, use of antiplatelet and nonsteroidal anti-inflammatory drug, the hazard ratio of colorectal cancer contrasting minor-allele (T) carriers vs. major-allele (GG) homozygotes was 2.17 (95% confidence interval, 1.18-3.99; P = 0.013). Bootstrapped analyses, from which we randomly excluded from two to nine cancer cases, provided confirmatory results. In participants with methylation data, we applied partial least square discriminant analysis (PLS-DA) and identified two methylation sites associated with higher colorectal cancer risk and two with lower risk. In-silico analysis suggested that methylation of the PEAR1 promoter at these four sites might affect binding of transcription factors p53, PAX5, and E2F-1, thereby modulating gene expression. In conclusion, our findings suggest that genetic and epigenetic variation in PEAR1 modulates the risk of colorectal cancer in white Flemish. To what extent, environmental factors as exemplified by our methylation data, interact with genetic predisposition and modulate penetrance of colorectal cancer risk is unknown. The European Union (HEALTH-F7-305507 HOMAGE), the European Research Council (Advanced Researcher Grant 2011-294713-EPLORE and Proof-of-Concept Grant 713601-uPROPHET), the European Research Area Net for Cardiovascular Diseases (JTC2017-046-PROACT), and the Research Foundation Flanders, Ministry of the Flemish Community, Brussels, Belgium (G.0881.13, G.0A65.14N, 1508715N, and 12M2715N) supported FLEMENGHO; grants 1508715N and 12M2715N supported the epigenetic analyses. The data for external replication analyses in the current publication were obtained from the dbGaP web site, under phs001078.v1.p1 (https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001078.v1.p1). Funding for Genetics & Epidemiology of Colorectal Cancer Consortium (GECCO), PHS, and DALS was provided by the National Institutes of Health of the United States of America (NIH, U01 CA137088, R01 CA059045, R01 CA042182, R01 CA137178, P50 CA127003, and R01 CA48998). The study also receives funding from Science and Technology Commission of Shanghai Municipality, Shanghai, China (21TS1400300 and Shanghai Pujiang Program-20PJ1412700). The funding sources had no role in study design, data extraction, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had responsibility for the decision to submit for publication.The authors gratefully acknowledge the approval of Drs. Ulrike Peters and Martha Slattery for the access to the PHS and DALS data and the clerical assistance of Renilde Wolfs.

Published
2022

46. OUTCOME-BASED THRESHOLD FOR CAROTID-FEMORAL PULSE WAVE VELOCITY: THE IDCARS STUDY

Author

An, Dewei, primary, Cheng, Yi-Bang, additional, Aparicio, Lucas S., additional, Thijs, Lutgarde, additional, Huang, Qi-Fang, additional, Wei, Fang-Fei, additional, Barochiner, Jessica, additional, Sheng, Chang-Sheng, additional, Yang, Wen-Yi, additional, Niiranen, Teemu J., additional, Boggia, José, additional, Stolarz-Skrzypek, Katarzyna, additional, Gilis-Malinowska, Natasza, additional, Tikhonoff, Valérie, additional, Wojciechowska, Wiktoria, additional, Casiglia, Edoardo, additional, Narkiewicz, Krzysztof, additional, Filipovský, Jan, additional, Kawecka-Jaszcz, Kalina, additional, Wang, Ji-Guang, additional, Li, Yan, additional, and Staessen, Jan A., additional

Published
2022
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47. RISK STRATIFICATION BY CROSS-CLASSIFICATION OF CENTRAL AND BRACHIAL SYSTOLIC BLOOD PRESSURE

Author

Cheng, Yi-Bang, primary, Thijs, Lutgarde, additional, Aparicio, Lucas S., additional, Huang, Qi-Fang, additional, Wei, Fang-Fei, additional, Yu, Yu-Ling, additional, Barochiner, Jessica, additional, Sheng, Chang-Sheng, additional, Yang, Wen-Yi, additional, Niiranen, Teemu J., additional, Boggia, José, additional, Zhang, Zhen-Yu, additional, Stolarz-Skrzypek, Katarzyna, additional, Gilis-Malinowska, Natasza, additional, Tikhonoff, Valérie, additional, Wojciechowska, Wiktoria, additional, Casiglia, Edoardo, additional, Narkiewicz, Krzysztof, additional, Filipovský, Jan, additional, Kawecka-Jaszcz, Kalina, additional, Wang, Ji-Guang, additional, Li, Yan, additional, and Staessen, Jan A., additional

Published
2022
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50. Prognostic Implication of Admission Mean and Pulse Pressure in Acute Decompensated Heart Failure With Different Phenotypes.

Author

Chen, Chen, Chen, Xuwei, Chen, Shilan, Wu, Yuzhong, He, Xin, Zhao, Jingjing, Li, Bin, He, Jiangui, Dong, Yugang, Liu, Chen, and Wei, Fang-Fei

Subjects
PROGNOSIS, HEART failure, WOMEN'S mortality, HEART failure patients, PHENOTYPES
Abstract

Background It remains unknown whether admission mean (MAP) and pulse pressure (PP) pressure are associated with short- and long-term mortality in Chinese patients with heart failure with preserved (HFpEF), mid-range (HFmrEF), and reduced (HFrEF) ejection fraction. Methods In 2,706 acute decompensated heart failure (HF) patients, we assessed the risk of 30-day, 1-year, and long-term (>1 year) mortality with 1-SD increment in MAP and PP, using multivariable logistic and Cox regression, respectively. Results During a median follow-up of 4.1 years, 1,341 patients died. The 30-day, 1-year, and long-term mortality were 3.5%, 16.7%, and 39.4%, respectively. A lower MAP was associated with a higher risk of 30-day mortality in women (P = 0.023) and a higher risk of 30-day and 1-year mortality in men (P ≤ 0.006), while higher PP predicted long-term mortality in men (P ≤ 0.014) with no relationship observed in women. In adjusted analyses additionally accounted for PP, 1-SD increment in MAP was associated with 30-day mortality in HFpEF (odds ratio [OR], 0.63; 95% CI, 0.43 to 0.92; P = 0.018), with 1-year mortality in HFmrEF (OR, 0.46; 95% CI, 0.32 to 0.66; P < 0.001) and HFrEF (OR, 0.54; 95% CI, 0.40 to 0.72; P < 0.001). In the adjusted model additionally accounted for MAP, 1-SD increment in PP was associated with long-term mortality in HFpEF (hazard ratio, 1.16; 95% CI, 1.05 to 1.28; P = 0.003). Conclusions A lower MAP was associated with a higher risk of short-term mortality in all HF subtypes, while a higher PP predicted a higher risk of long-term mortality in men and in HFpEF. Our observations highlight the clinical importance of admission blood pressure for risk stratification in HF subtypes. [ABSTRACT FROM AUTHOR]

Published
2023
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