Even a Low Comorbidity Burden Predicts Poor Outcomes in Chronic Heart Failure
Catarina Elias1,2, Ana Neves1,2, Rita Gouveia1,2
1From the Serviço de Medicina Interna do Centro Hospitalar e Universitário de São João, Porto, Portugal.
Critical Pathways in Cardiology
|June 21, 2024
Summary
Multiple cardiovascular risk factors (CVRFs) and comorbidities (CMBs) significantly increase heart failure mortality. Assessing CVRFs and CMBs is crucial for managing heart failure patients and improving prognosis.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Heart failure patients frequently present with multiple cardiovascular risk factors (CVRFs) and comorbidities (CMBs).
- The cumulative impact of these conditions on heart failure prognosis requires further evaluation.
Purpose of the Study:
- To assess the prognostic impact of additive cardiovascular risk factors and comorbidities in patients with systolic dysfunction.
- To determine if an increased burden of CVRFs and CMBs independently affects all-cause mortality.
Main Methods:
- Retrospective analysis of ambulatory patients with systolic dysfunction (Jan 2012 - May 2018).
- Follow-up until Jan 2021, with all-cause death as the primary endpoint.
- CVRFs included hypertension, diabetes, smoking; CMBs included various chronic conditions and atrial fibrillation. Patients were classified by the number of CVRFs/CMBs (<2 and ≥2).
Main Results:
- A significant proportion of patients had multiple comorbidities (67.9%).
- Mortality was higher in patients with ≥2 CVRFs (56.1%) and ≥2 CMBs (57.7%) compared to those with fewer.
- Patients with ≥2 CVRFs/CMBs faced a more than doubled risk of dying (adjusted HR, 2.20).
Conclusions:
- The presence of two or more cardiovascular risk factors or comorbidities significantly elevates mortality risk in heart failure patients.
- Routine assessment of CVRFs and CMBs is recommended for comprehensive patient management and improved outcomes.
More Related Videos
04:05Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
1.8K
07:13A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
Published on: April 30, 2020
6.4K
Related Concept Videos
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
2.7K
Understanding the variety of primary symptoms and systemic complications that characterize chronic obstructive pulmonary disease (COPD) is crucial for healthcare professionals.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
2.7K
01:22Heart Failure Drugs: β-Blockers
336
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
336
01:22Heart Failure Drugs: Diuretics
363
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
363
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.5K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.5K