期刊
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
卷 28, 期 9, 页码 924-934出版社
OXFORD UNIV PRESS
DOI: 10.1177/2047487320922636
关键词
Early stage; heart failure; stage A; stage B; risk factor
资金
- German Ministry of Research and Education within the Comprehensive Heart Failure Centre Wurzburg [BMBF 01EO1004, 01EO1504]
- German Research Foundation (DFG)
- University of Wurzburg
- Interdisciplinary Bank of Biomaterials and Data of the University Hospital of Wurzburg
- Julius Maximilian University of Wurzburg (ibdw)
- Federal Ministry for Education and Research [FKZ: 01EY1102]
This study aimed to identify individuals at risk of heart failure in the general population by investigating a representative sample in Germany. They found a group of asymptomatic individuals with cardiac dysfunction predisposing to heart failure, who lacked established heart failure risk factors and therefore would have been missed by conventional primary prevention methods. Further studies are needed to replicate these findings and characterize their genetic and -omic profiles for better prevention strategies.
Aims Prevention of heart failure relies on the early identification and control of risk factors. We aimed to identify the frequency and characteristics of individuals at risk of heart failure in the general population. Methods and Results We report cross-sectional data from the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of residents of Wurzburg, Germany. Sampling was stratified 1:1 for sex and 10:27:27:27:10 for age groups of 30-39/40-49/50-59/60-69/70-79 years. Heart failure precursor stages were defined according to American College of Cardiology/American Heart Association: stage A (risk factors for heart failure), stage B (asymptomatic cardiac dysfunction). The main results were internally validated in the second half of the participants. The derivation sample comprised 2473 participants (51% women) with a distribution of 10%/28%/25%/27%/10% in respective age groups. Stages A and B were prevalent in 42% and 17% of subjects, respectively. Of stage B subjects, 31% had no risk factor qualifying for stage A (group 'B-not-A'). Compared to individuals in stage B with A criteria, B-not-A were younger, more often women, and had left ventricular dilation as the predominant B qualifying criterion (all P < 0.001). These results were confirmed in the validation sample (n = 2492). Conclusion We identified a hitherto undescribed group of asymptomatic individuals with cardiac dysfunction predisposing to heart failure, who lacked established heart failure risk factors and therefore would have been missed by conventional primary prevention. Further studies need to replicate this finding in independent cohorts and characterise their genetic and -omic profile and the inception of clinically overt heart failure in subjects of group B-not-A.
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