Baseline characteristics of patients with heart failure and preserved ejection fraction included in the Karolinska Rennes (KaRen) study

Arch Cardiovasc Dis. 2014 Feb;107(2):112-21. doi: 10.1016/j.acvd.2013.11.002. Epub 2013 Dec 30.

Abstract

Background: Karolinska Rennes (KaRen) is a prospective observational study to characterize heart failure patients with preserved ejection fraction (HFpEF) and to identify prognostic factors for long-term mortality and morbidity.

Aims: To report characteristics and echocardiography at entry and after 4-8 weeks of follow-up.

Methods: Patients were included following an acute heart failure presentation with B-type natriuretic peptide (BNP)>100 ng/L or N-terminal pro-BNP (NT-proBNP)>300 ng/L and left ventricular ejection fraction (LVEF)>45%.

Results: The mean ± SD age of 539 included patients was 77 ± 9 years and 56% were women. Patient history included hypertension (78%), atrial tachyarrhythmia (44%), prior heart failure (40%) and anemia (37%), but left bundle branch block was rare (3.8%). Median NT-proBNP was 2448 ng/L (n=438), and median BNP 429 ng/L (n=101). Overall, 101 patients did not return for the follow-up visit, including 13 patients who died (2.4%). Apart from older age (80 ± 9 vs. 76 ± 9 years; P=0.006), there were no significant differences in baseline characteristics between patients who did and did not return for follow-up. Mean LVEF was lower at entry than follow-up (56% vs. 62%; P<0.001). At follow-up, mean E/e' was 12.9 ± 6.1, left atrial volume index 49.4±17.8mL/m(2). Mean global left ventricular longitudinal strain was -14.6 ± 3.9%; LV mass index was 126.6 ± 36.2g/m(2).

Conclusions: Patients in KaRen were old with slight female dominance and hypertension as the most prevalent etiological factor. LVEF was preserved, but with increased LV mass and depressed LV diastolic and longitudinal systolic functions. Few patients had signs of electrical dyssynchrony (ClinicalTrials.gov.- NCT00774709).

Keywords: Caractéristiques cliniques; Clinical characteristics; Echocardiographic characteristics; Heart failure with preserved ejection fraction; Insuffisance cardiaque à fraction d’éjection préservée; Registre; Registry; Échocardiographie.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Comorbidity
  • Echocardiography
  • Electrocardiography
  • Female
  • France / epidemiology
  • Heart Failure / blood
  • Heart Failure / diagnosis
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Humans
  • Hypertension / epidemiology
  • Male
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk Factors
  • Sex Factors
  • Stroke Volume*
  • Sweden / epidemiology
  • Time Factors
  • Ventricular Function, Left*

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain

Associated data

  • ClinicalTrials.gov/NCT00774709