Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD
Background The progression of left ventricular diastolic dysfunction (LVDD) over time may lead to the development of heart failure with preserved ejection fraction (HFpEF). HFpEF is twice as common in women compared with men; however, the sex-specific progression from LVDD towards HFpEF is poorly de...
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BMJ Publishing Group
2025-05-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003105.full |
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| author | N Charlotte Onland-Moret Frans H Rutten Arco J Teske Roxana Menken Hester M den Ruijter M Louis Handoko Marianne C Verhaar Dirk J Duncker Maarten Jan Cramer Anne Margje Lisa Naomi van Ommen Elisa Dal Canto Ernest Diez Benavente Karim Taha |
| author_facet | N Charlotte Onland-Moret Frans H Rutten Arco J Teske Roxana Menken Hester M den Ruijter M Louis Handoko Marianne C Verhaar Dirk J Duncker Maarten Jan Cramer Anne Margje Lisa Naomi van Ommen Elisa Dal Canto Ernest Diez Benavente Karim Taha |
| author_sort | N Charlotte Onland-Moret |
| collection | DOAJ |
| description | Background The progression of left ventricular diastolic dysfunction (LVDD) over time may lead to the development of heart failure with preserved ejection fraction (HFpEF). HFpEF is twice as common in women compared with men; however, the sex-specific progression from LVDD towards HFpEF is poorly described. Therefore, we aim to evaluate changes over time in markers of LVDD severity and HFpEF in women and men with preclinical LVDD.Methods and results We reassessed 146 participants from the HELPFul study (58% women and 42% men) with preclinical LVDD after a median follow-up of 4.3 (IQR: 3.9–4.7) years. The follow-up measurements mirrored baseline measurements, encompassing clinical examination, blood draw for biomarkers and echocardiography. We determined HFpEF incidence and report changes over time in echocardiography. Additionally, we studied how blood pressure and kidney function affected LVDD progression, including plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, using generalised mixed models. All analyses were performed for women and men combined, and sex stratified. Out of 146 participants, 15 (10%) developed HF of whom 13 had HFpEF (9 women and 4 men). Over time, mean kidney function (estimated glomerular filtration rate, eGFR) declined from 89±14.4 to 81±16.9 mL/min/1.73 m2 and median NT-proBNP plasma levels increased from 71 (IQR: 44–120) to 100 (IQR: 51–157) pg/mL. In women, a higher systolic and in men a higher diastolic blood pressure were associated with an increase in NT-proBNP plasma levels over time. Lower eGFR levels were related to increased NT-proBNP plasma levels over time in both men and women.Conclusions Our study demonstrates that only a small proportion of women and men with preclinical LVDD develop incident HF over a roughly 5-year follow-up period. High blood pressure and decreased kidney function were associated with higher levels of NT-proBNP. This highlights the need to further explore cardiorenal protection as a method to prevent HFpEF. |
| format | Article |
| id | doaj-art-aa5386fe88e8464ab4f64cfaf84556dc |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-aa5386fe88e8464ab4f64cfaf84556dc2025-08-20T02:11:21ZengBMJ Publishing GroupOpen Heart2053-36242025-05-0112110.1136/openhrt-2024-003105Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDDN Charlotte Onland-Moret0Frans H Rutten1Arco J Teske2Roxana Menken3Hester M den Ruijter4M Louis Handoko5Marianne C Verhaar6Dirk J Duncker7Maarten Jan Cramer8Anne Margje Lisa Naomi van Ommen9Elisa Dal Canto10Ernest Diez Benavente11Karim Taha12Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The NetherlandsJulius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The NetherlandsDepartment of Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsCardiology Centers of the Netherlands, Utrecht, The NetherlandsLaboratory of Experimental Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsDepartment of Cardiology, Amsterdam University Medical Center, Amsterdam, The NetherlandsDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Cardiology, Erasmus University Medical Center, Rotterdam, The NetherlandsDepartment of Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsLaboratory of Experimental Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsLaboratory of Experimental Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsLaboratory of Experimental Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsDepartment of Cardiology, University Medical Center, Utrecht University, Utrecht, The NetherlandsBackground The progression of left ventricular diastolic dysfunction (LVDD) over time may lead to the development of heart failure with preserved ejection fraction (HFpEF). HFpEF is twice as common in women compared with men; however, the sex-specific progression from LVDD towards HFpEF is poorly described. Therefore, we aim to evaluate changes over time in markers of LVDD severity and HFpEF in women and men with preclinical LVDD.Methods and results We reassessed 146 participants from the HELPFul study (58% women and 42% men) with preclinical LVDD after a median follow-up of 4.3 (IQR: 3.9–4.7) years. The follow-up measurements mirrored baseline measurements, encompassing clinical examination, blood draw for biomarkers and echocardiography. We determined HFpEF incidence and report changes over time in echocardiography. Additionally, we studied how blood pressure and kidney function affected LVDD progression, including plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, using generalised mixed models. All analyses were performed for women and men combined, and sex stratified. Out of 146 participants, 15 (10%) developed HF of whom 13 had HFpEF (9 women and 4 men). Over time, mean kidney function (estimated glomerular filtration rate, eGFR) declined from 89±14.4 to 81±16.9 mL/min/1.73 m2 and median NT-proBNP plasma levels increased from 71 (IQR: 44–120) to 100 (IQR: 51–157) pg/mL. In women, a higher systolic and in men a higher diastolic blood pressure were associated with an increase in NT-proBNP plasma levels over time. Lower eGFR levels were related to increased NT-proBNP plasma levels over time in both men and women.Conclusions Our study demonstrates that only a small proportion of women and men with preclinical LVDD develop incident HF over a roughly 5-year follow-up period. High blood pressure and decreased kidney function were associated with higher levels of NT-proBNP. This highlights the need to further explore cardiorenal protection as a method to prevent HFpEF.https://openheart.bmj.com/content/12/1/e003105.full |
| spellingShingle | N Charlotte Onland-Moret Frans H Rutten Arco J Teske Roxana Menken Hester M den Ruijter M Louis Handoko Marianne C Verhaar Dirk J Duncker Maarten Jan Cramer Anne Margje Lisa Naomi van Ommen Elisa Dal Canto Ernest Diez Benavente Karim Taha Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD Open Heart |
| title | Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD |
| title_full | Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD |
| title_fullStr | Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD |
| title_full_unstemmed | Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD |
| title_short | Incident HFpEF and time-dependent changes in markers of LVDD severity in women and men with preclinical LVDD |
| title_sort | incident hfpef and time dependent changes in markers of lvdd severity in women and men with preclinical lvdd |
| url | https://openheart.bmj.com/content/12/1/e003105.full |
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