Outcomes and Worsening Renal Function in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) has been described as a disease of elderly subjects with female predominance and hypertension. Our clinical experience suggests patients with HFpEF from an urban population are far more heterogenous, with greater co-morbidities and significant i...
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| Veröffentlicht in: | The American journal of cardiology 2015-11, Vol.116 (10), p.1534-1540 |
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| creator | Sharma, Kavita, MD Hill, Terence, MD Grams, Morgan, MD, PhD Daya, Natalie R., MPH Hays, Allison G., MD Fine, Derek, MD Thiemann, David R., MD Weiss, Robert G., MD Tedford, Ryan J., MD Kass, David A., MD Schulman, Steven P., MD Russell, Stuart D., MD |
| description | Heart failure with preserved ejection fraction (HFpEF) has been described as a disease of elderly subjects with female predominance and hypertension. Our clinical experience suggests patients with HFpEF from an urban population are far more heterogenous, with greater co-morbidities and significant inhospital morbidity. There are limited data on the hospitalization course and outcomes in acute decompensated HFpEF. Hospitalizations for acute heart failure at our institution from July 2011 to June 2012 were identified by International Classification of Diseases, Ninth Revision , codes and physician review for left ventricular ejection fraction ≥50% and were reviewed for patient characteristics and clinical outcomes. Worsening renal function (WRF) was defined as creatinine increase of ≥0.3 mg/dl by 72 hours after admission. Hospital readmission and mortality data were captured from electronic medical records and the Social Security Death Index. Of 434 heart failure admissions, 206 patients (47%) with HFpEF were identified. WRF developed in 40%, the highest reported in HFpEF to date, and was associated with higher blood pressure and lower volume of diuresis. Compared to previous reports, hospitalized patients with HFpEF were younger (mean age 63.2 ± 13.6 years), predominantly black (74%), and had more frequent and severe co-morbidities: hypertension (89%), diabetes (56%), and chronic kidney disease (55%). There were no significant differences in 1- and 12-month outcomes by gender, race, or WRF. In conclusion, we found hospitalized patients with HFpEF from an urban population develop a high rate of WRF are younger than previous cohorts, often black, and have greater co-morbidities than previously described. |
| doi_str_mv | 10.1016/j.amjcard.2015.08.019 |
| format | Article |
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Our clinical experience suggests patients with HFpEF from an urban population are far more heterogenous, with greater co-morbidities and significant inhospital morbidity. There are limited data on the hospitalization course and outcomes in acute decompensated HFpEF. Hospitalizations for acute heart failure at our institution from July 2011 to June 2012 were identified by International Classification of Diseases, Ninth Revision , codes and physician review for left ventricular ejection fraction ≥50% and were reviewed for patient characteristics and clinical outcomes. Worsening renal function (WRF) was defined as creatinine increase of ≥0.3 mg/dl by 72 hours after admission. Hospital readmission and mortality data were captured from electronic medical records and the Social Security Death Index. Of 434 heart failure admissions, 206 patients (47%) with HFpEF were identified. WRF developed in 40%, the highest reported in HFpEF to date, and was associated with higher blood pressure and lower volume of diuresis. Compared to previous reports, hospitalized patients with HFpEF were younger (mean age 63.2 ± 13.6 years), predominantly black (74%), and had more frequent and severe co-morbidities: hypertension (89%), diabetes (56%), and chronic kidney disease (55%). There were no significant differences in 1- and 12-month outcomes by gender, race, or WRF. In conclusion, we found hospitalized patients with HFpEF from an urban population develop a high rate of WRF are younger than previous cohorts, often black, and have greater co-morbidities than previously described.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2015.08.019</identifier><identifier>PMID: 26410603</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Disease Progression ; Female ; Follow-Up Studies ; Glomerular Filtration Rate - physiology ; Heart attacks ; Heart Failure - complications ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Hospitalization ; Humans ; Incidence ; Inpatients ; Male ; Maryland - epidemiology ; Middle Aged ; Mortality ; Prognosis ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - etiology ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Risk Factors ; Stroke Volume - physiology ; Ventricular Function, Left - physiology ; Womens health</subject><ispartof>The American journal of cardiology, 2015-11, Vol.116 (10), p.1534-1540</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 15, 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-5055f45bb334212f69a3a664c51eda9ca89e69d2a805bff2c2d26a81e20de62b3</citedby><cites>FETCH-LOGICAL-c448t-5055f45bb334212f69a3a664c51eda9ca89e69d2a805bff2c2d26a81e20de62b3</cites><orcidid>0000-0002-3012-1765 ; 0000-0001-6996-9475 ; 0000-0003-1115-0349</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914915018469$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26410603$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sharma, Kavita, MD</creatorcontrib><creatorcontrib>Hill, Terence, MD</creatorcontrib><creatorcontrib>Grams, Morgan, MD, PhD</creatorcontrib><creatorcontrib>Daya, Natalie R., MPH</creatorcontrib><creatorcontrib>Hays, Allison G., MD</creatorcontrib><creatorcontrib>Fine, Derek, MD</creatorcontrib><creatorcontrib>Thiemann, David R., MD</creatorcontrib><creatorcontrib>Weiss, Robert G., MD</creatorcontrib><creatorcontrib>Tedford, Ryan J., MD</creatorcontrib><creatorcontrib>Kass, David A., MD</creatorcontrib><creatorcontrib>Schulman, Steven P., MD</creatorcontrib><creatorcontrib>Russell, Stuart D., MD</creatorcontrib><title>Outcomes and Worsening Renal Function in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Heart failure with preserved ejection fraction (HFpEF) has been described as a disease of elderly subjects with female predominance and hypertension. Our clinical experience suggests patients with HFpEF from an urban population are far more heterogenous, with greater co-morbidities and significant inhospital morbidity. There are limited data on the hospitalization course and outcomes in acute decompensated HFpEF. Hospitalizations for acute heart failure at our institution from July 2011 to June 2012 were identified by International Classification of Diseases, Ninth Revision , codes and physician review for left ventricular ejection fraction ≥50% and were reviewed for patient characteristics and clinical outcomes. Worsening renal function (WRF) was defined as creatinine increase of ≥0.3 mg/dl by 72 hours after admission. Hospital readmission and mortality data were captured from electronic medical records and the Social Security Death Index. Of 434 heart failure admissions, 206 patients (47%) with HFpEF were identified. WRF developed in 40%, the highest reported in HFpEF to date, and was associated with higher blood pressure and lower volume of diuresis. Compared to previous reports, hospitalized patients with HFpEF were younger (mean age 63.2 ± 13.6 years), predominantly black (74%), and had more frequent and severe co-morbidities: hypertension (89%), diabetes (56%), and chronic kidney disease (55%). There were no significant differences in 1- and 12-month outcomes by gender, race, or WRF. In conclusion, we found hospitalized patients with HFpEF from an urban population develop a high rate of WRF are younger than previous cohorts, often black, and have greater co-morbidities than previously described.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Heart attacks</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Incidence</subject><subject>Inpatients</subject><subject>Male</subject><subject>Maryland - epidemiology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Prognosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke Volume - physiology</subject><subject>Ventricular Function, Left - physiology</subject><subject>Womens health</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkktv1DAUhS0EotOBnwCKxIZNgu3Err0BoarDIFVqxUMsrRvnBhwSZ7CTSuXX19NMW6mbrvzQd47lcy4hbxgtGGXyQ1fA0FkITcEpEwVVBWX6GVkxdaJzpln5nKwopTzXrNJH5DjGLh0ZE_IlOeKyYlTSckXCxTzZccCYgW-yX2OI6J3_nX1DD322mb2d3Ogz57NLmBz6KWbbMe7cBL37j0nhpj_ZFiFM2QZcPwdcri4DRgxXiTjrcPHYBLjdvCIvWugjvj6sa_Jzc_bjdJufX3z5evr5PLdVpaZcUCHaStR1WVac8VZqKEHKygqGDWgLSqPUDQdFRd223PKGS1AMOW1Q8rpck_eL7y6M_2aMkxlctNj34HGco2EnXJeV5qpM6LtHaDfOISVwSynJKU_YmoiFsmGMMWBrdsENEK4No2ZfiunMoRSzL8VQZVIpSff24D7XAzb3qrsWEvBpATDFceUwmGhT1hYbF1J4phndk098fORge-edhf4vXmN8-I2J3FDzfT8Z-8FggjJVSV3eAPBntSc</recordid><startdate>20151115</startdate><enddate>20151115</enddate><creator>Sharma, Kavita, MD</creator><creator>Hill, Terence, MD</creator><creator>Grams, Morgan, MD, PhD</creator><creator>Daya, Natalie R., MPH</creator><creator>Hays, Allison G., MD</creator><creator>Fine, Derek, MD</creator><creator>Thiemann, David R., MD</creator><creator>Weiss, Robert G., MD</creator><creator>Tedford, Ryan J., MD</creator><creator>Kass, David A., MD</creator><creator>Schulman, Steven P., MD</creator><creator>Russell, Stuart D., MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3012-1765</orcidid><orcidid>https://orcid.org/0000-0001-6996-9475</orcidid><orcidid>https://orcid.org/0000-0003-1115-0349</orcidid></search><sort><creationdate>20151115</creationdate><title>Outcomes and Worsening Renal Function in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction</title><author>Sharma, Kavita, MD ; Hill, Terence, MD ; Grams, Morgan, MD, PhD ; Daya, Natalie R., MPH ; Hays, Allison G., MD ; Fine, Derek, MD ; Thiemann, David R., MD ; Weiss, Robert G., MD ; Tedford, Ryan J., MD ; Kass, David A., MD ; Schulman, Steven P., MD ; Russell, Stuart D., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-5055f45bb334212f69a3a664c51eda9ca89e69d2a805bff2c2d26a81e20de62b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cardiology</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Heart attacks</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Incidence</topic><topic>Inpatients</topic><topic>Male</topic><topic>Maryland - epidemiology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Prognosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - etiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke Volume - physiology</topic><topic>Ventricular Function, Left - physiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sharma, Kavita, MD</creatorcontrib><creatorcontrib>Hill, Terence, MD</creatorcontrib><creatorcontrib>Grams, Morgan, MD, PhD</creatorcontrib><creatorcontrib>Daya, Natalie R., MPH</creatorcontrib><creatorcontrib>Hays, Allison G., MD</creatorcontrib><creatorcontrib>Fine, Derek, MD</creatorcontrib><creatorcontrib>Thiemann, David R., MD</creatorcontrib><creatorcontrib>Weiss, Robert G., MD</creatorcontrib><creatorcontrib>Tedford, Ryan J., MD</creatorcontrib><creatorcontrib>Kass, David A., MD</creatorcontrib><creatorcontrib>Schulman, Steven P., MD</creatorcontrib><creatorcontrib>Russell, Stuart D., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sharma, Kavita, MD</au><au>Hill, Terence, MD</au><au>Grams, Morgan, MD, PhD</au><au>Daya, Natalie R., MPH</au><au>Hays, Allison G., MD</au><au>Fine, Derek, MD</au><au>Thiemann, David R., MD</au><au>Weiss, Robert G., MD</au><au>Tedford, Ryan J., MD</au><au>Kass, David A., MD</au><au>Schulman, Steven P., MD</au><au>Russell, Stuart D., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes and Worsening Renal Function in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2015-11-15</date><risdate>2015</risdate><volume>116</volume><issue>10</issue><spage>1534</spage><epage>1540</epage><pages>1534-1540</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Heart failure with preserved ejection fraction (HFpEF) has been described as a disease of elderly subjects with female predominance and hypertension. Our clinical experience suggests patients with HFpEF from an urban population are far more heterogenous, with greater co-morbidities and significant inhospital morbidity. There are limited data on the hospitalization course and outcomes in acute decompensated HFpEF. Hospitalizations for acute heart failure at our institution from July 2011 to June 2012 were identified by International Classification of Diseases, Ninth Revision , codes and physician review for left ventricular ejection fraction ≥50% and were reviewed for patient characteristics and clinical outcomes. Worsening renal function (WRF) was defined as creatinine increase of ≥0.3 mg/dl by 72 hours after admission. Hospital readmission and mortality data were captured from electronic medical records and the Social Security Death Index. Of 434 heart failure admissions, 206 patients (47%) with HFpEF were identified. WRF developed in 40%, the highest reported in HFpEF to date, and was associated with higher blood pressure and lower volume of diuresis. Compared to previous reports, hospitalized patients with HFpEF were younger (mean age 63.2 ± 13.6 years), predominantly black (74%), and had more frequent and severe co-morbidities: hypertension (89%), diabetes (56%), and chronic kidney disease (55%). There were no significant differences in 1- and 12-month outcomes by gender, race, or WRF. In conclusion, we found hospitalized patients with HFpEF from an urban population develop a high rate of WRF are younger than previous cohorts, often black, and have greater co-morbidities than previously described.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26410603</pmid><doi>10.1016/j.amjcard.2015.08.019</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3012-1765</orcidid><orcidid>https://orcid.org/0000-0001-6996-9475</orcidid><orcidid>https://orcid.org/0000-0003-1115-0349</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Cardiology Cardiovascular Cardiovascular disease Disease Progression Female Follow-Up Studies Glomerular Filtration Rate - physiology Heart attacks Heart Failure - complications Heart Failure - diagnosis Heart Failure - physiopathology Hospitalization Humans Incidence Inpatients Male Maryland - epidemiology Middle Aged Mortality Prognosis Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - etiology Renal Insufficiency, Chronic - physiopathology Retrospective Studies Risk Factors Stroke Volume - physiology Ventricular Function, Left - physiology Womens health |
| title | Outcomes and Worsening Renal Function in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction |
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