Cardiac dysfunction and noncardiac dysfunction as precursors of heart failure with reduced and preserved ejection...

Area of Science:

• Cardiology
• Gerontology
• Internal Medicine

Background:

• Heart failure (HF) is a complex syndrome affecting multiple organ systems.
• Limited longitudinal data exist on subclinical cardiac dysfunction preceding overt HF.
• The role of noncardiac dysfunction in HF progression remains unclear.

Purpose of the Study:

• To investigate if subclinical cardiac and noncardiac organ dysfunction accelerate HF manifestation.
• To assess the predictive value of various organ system dysfunctions on HF incidence.

Main Methods:

• Analysis of 1038 Framingham Heart Study participants (mean age 76 years).
• Assessment of left ventricular systolic and diastolic function.
• Evaluation of renal (serum creatinine), hepatic (serum albumin), pulmonary (FEV1:FVC ratio), hematologic (hemoglobin), and inflammatory (white blood cell count) markers.

Main Results:

• Antecedent left ventricular systolic and diastolic dysfunction significantly increased HF risk.
• Higher serum creatinine, lower FEV1:FVC ratios, and lower hemoglobin concentrations predicted increased HF risk, independent of cardiac function.
• Subclinical dysfunction in any noncardiac organ system was associated with a 30% increased HF risk.

Conclusions:

• Pre-existing cardiac dysfunction and noncardiac organ dysfunction are linked to a higher incidence of heart failure.
• HF is a progressive condition where noncardiac factors play a crucial role.
• Early identification of organ dysfunction is important for HF management.