Serum Albumin Is a Marker of Myocardial Fibrosis, Adverse Pulsatile Aortic Hemodynamics, and Prognosis in Heart Failure With Preserved Ejection Fraction

• DOI: 10.1161/jaha.119.014716
• Publication Date: 2020-02-03T11:12:30Z
• Authors: Stuart B. Prenner; Raj Pillutla; Sowjanya Yenigalla; Sowmya Gaddam; Jonathan Lee; Mary Jo Obeid; Armghan Haider Ans; Qasim Jehangir; Jessica Kim; Payman Zamani; Jeremy A. Mazurek; Scott R. Akers; Julio A. Chirinos
• Keywords: Pulsatile flow; Myocardial fibrosis

Background Data regarding the phenotypic correlates and prognostic value of albumin in heart failure with preserved ejection fraction (HFpEF) are scarce. The goal current study is to determine (myocardial hypertrophy, myocardial fibrosis, detailed pulsatile hemodynamics, skeletal muscle mass) implications serum HFpEF. Methods Results We studied 118 adults All-cause death or heart-failure-related hospitalization was ascertained over a median follow-up 57.6 months. measured left ventricular mass, extracellular volume, axial areas using magnetic resonance imaging. Pulsatile arterial hemodynamics were assessed combination tonometry phase-contrast Subjects lower exhibited higher body mass index, greater proportion black ethnicity diabetes mellitus. A low associated volume (52.3 versus 57.4 39.3 mL lowest highest tertile, respectively; P=0.0023) N-terminal pro B-type natriuretic peptide levels, but not cellular (123 114 102 mL; P=0.13). Lower also an increased forward wave amplitude markedly power aorta. Serum strong predictor even after adjustment for levels Meta-Analysis Global Group Chronic Heart Failure (MAGGIC) risk score (adjusted standardized hazard ratio=0.56; 95% CI=0.37-0.83; P<0.0001). Conclusions adverse aortic prognosis This readily available clinical biomarker can enhance stratification HFpEF identifies subgroup specific pathophysiological abnormalities.