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Heart failure with preserved ejection fraction in African Americans: The ARIC (Atherosclerosis Risk In Communities) study.

TitleHeart failure with preserved ejection fraction in African Americans: The ARIC (Atherosclerosis Risk In Communities) study.
Publication TypeJournal Article
Year of Publication2013
AuthorsGupta DK, Shah AM, Castagno D, Takeuchi M, Loehr LR, Fox ER, Butler KR, Mosley TH, Kitzman DW
Secondary AuthorsSolomon SD
JournalJACC Heart Fail
Volume1
Issue2
Pagination156-63
Date Published2013 Apr
ISSN2213-1787
KeywordsAfrican Americans, Aged, Atherosclerosis, Female, Heart Failure, Humans, Male, Middle Aged, Prospective Studies, Risk Assessment, Stroke Volume
Abstract

OBJECTIVES: In an entirely African-American cohort, we compared clinical characteristics, cardiac structure and function, and all-cause mortality in patients with heart failure (HF) with preserved ejection fraction (HFpEF) in relation to patients with heart failure with reduced ejection fraction (HFrEF) and those without HF.

BACKGROUND: African Americans are at increased risk for HF. Nevertheless, there are limited phenotypic and prognostic data in African Americans with HFpEF compared with those with HFrEF and those without HF.

METHODS: Middle-aged African Americans from the Jackson, Mississippi, cohort of the ARIC (Atherosclerosis Risk In Communities) study (n = 2,445) underwent echocardiography between 1993 and 1995. HF prevalence was available in 1,962 patients for whom left ventricular ejection fraction (LVEF) could be quantified. Participants with HF were categorized as having HFpEF (LVEF ≥50%), HFrEF (LVEF

RESULTS: HF was identified in 116 (5.9%) participants (HFpEF n = 85 [73%]; HFrEF n = 31 [27%]). Compared with those without HF, those with HFpEF were older, were more likely to be female, and had more frequent comorbidities and concentric hypertrophy. In relation to HFrEF, those with HFpEF were more likely to be female but less likely to have coronary heart disease, diabetes mellitus, chronic kidney disease, left atrial enlargement, and eccentric hypertrophy. Over a median 13.7 years of follow-up, risk of death differed between groups, with age- and sex-adjusted hazard ratios of 1.51 (95% confidence interval: 1.01 to 2.25) for HFpEF versus those without HF and 2.50 (95% confidence interval: 1.37 to 4.58) for HFrEF versus HFpEF.

CONCLUSIONS: In this cohort of middle-aged African Americans, HFpEF was the most common form of HF and was associated with a substantially better prognosis than HFrEF but worse than those without HF.

DOI10.1016/j.jchf.2013.01.003
Alternate JournalJACC Heart Fail
PubMed ID23671819
PubMed Central IDPMC3650857
Grant ListK08 HL116792 / HL / NHLBI NIH HHS / United States
T32 HL094301 / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
T32 HL094301-02 / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100006C / / PHS HHS / United States