Abstract 12749: Factors Influencing the Development of De Novo Heart Failure in Stage-B Asymptomatic Patients -A Report From the CHART-2 Study-
Background: Since heart failure (HF) is an urgent public health issue worldwide, the AHA/ACC guidelines strongly recommend the importance to prevent the development of HF in asymptomatic Stage-B patients. However, little is known about the etiology and predictors for the development of de novo HF in stage B patients.
Method: Among the 10,219 subjects registered in our cohort, named as the Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) study, we first compared the demographics and clinical outcomes between the 4,463 Stage-B patients with asymptomatic cardiac structure abnormalities (mean age 67.3 years, male 71.2%) and the 820 Stage-A patients with coronary artery disease without cardiac dysfunction (mean age 69.0 years, 69.2% male). We then analyzed the predictors for de novo HF in Stage-B patients.
Results: As an etiology, the prevalence of ischemic heart disease, valvular heart disease, and cardiomyopathy in Stage-B patients were 51.0, 19.1, and 10.0%, respectively. In Stage-B patients, as compared with Stage-A patients, left ventricular ejection fraction (LVEF) was significantly lower (64.5 vs. 70.4%, P<0.001) and B-type natriuretic peptide level was significantly higher (105.4 vs. 51.2 pg/ml, P<0.001). During the mean follow-up period of 2.8 years, the incidence of cardiovascular deaths (2.2 vs. 1.1%, P=0.036) or hospitalization due to de novo HF (3.5 vs. 1.6%, P=0.004) was significantly higher in Stage-B than in Stage-A patients, whereas non-cardiovascular mortality was comparable between the 2 groups (3.3 vs. 3.1%, P=0.605). A stepwise Cox regression analysis showed that several factors could be predictive for the development of de novo HF in Stage-B patients, including age (P=0.001), atrial fibrillation (AF, P=0.002), LVEF (P<0.001), hemoglobin level (P<0.001), estimated glomerular filtration ratio (P=0.015), statin use (P=0.001) and diabetes mellitus (DM, P=0.002).
Conclusions: These results indicate that several factors could influence the progression from Stage B to de novo HF, including AF, LV dysfunction, anemia, renal dysfunction, no statin use, and DM, suggesting that corrections of these factors could prevent the development of de-novo HF in Stage B patients.
- © 2012 by American Heart Association, Inc.