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Autonomic dysfunction is associated with cardiac remodeling in heart failure patients – The HARVEST study
Örebro University, School of Health Sciences.
2017 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Background: Orthostatic hypotension (OH) is a cardinal sign of autonomic dysfunction, and a common comorbidity in patients with heart failure. The relationship between OH and structural cardiac anomalies has not been sufficiently explored.

Purpose: To assess relations between orthostatic blood pressure (BP) responses during active standing and echocardiographic findings in patients with heart failure.

Methods: 149 patients hospitalized for heart failure (mean age: 74.0 years; mean ejection fraction (EF) 40±16%) were examined with conventional echocardiograms and active-standing test. Associations between left atrial volume, right atrial volume, left ventricular mass, left ventricular diameter and right ventricular diameter and the difference between supine and standing systolic/diastolic BP were examined.

Results: A total of 33 patients met conventional OH criteria i.e. systolic/diastolic BP decrease ≥20/10 mmHg. In linear regression models, decrease in systolic BP upon standing was associated with greater left ventricular mass. Decrease in systolic BP was also borderline significant associated with greater left atrial volume.

Conclusions: Orthostatic decline in systolic BP among older heart failure patients is associated with structural cardiac changes such as increased left ventricular mass, independently of traditional risk factors and LVEF.

Place, publisher, year, edition, pages
2017.
Keywords [en]
Orthostatic hypotension, heart failure, left ventricle mass and left atrium.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-61176OAI: oai:DiVA.org:oru-61176DiVA, id: diva2:1145315
Subject / course
Medicine
Available from: 2017-09-28 Created: 2017-09-28 Last updated: 2017-09-28Bibliographically approved

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CiteExportLink to record
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  • apa
  • harvard1
  • ieee
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  • sv-SE
  • Other locale
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Output format
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  • asciidoc
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