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H2FPEF score predicts atherosclerosis presence in patients with systemic connective tissue disease

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2021
H2FPEF_score_predicts_pub_2021.pdf (2.088Mb)
Authors
Vasilev, Vladimir
Popović, Dejana
Ristić, Gorica
Arena, Ross
Radunović, Goran
Ristić, Arsen
Article (Published version)
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Abstract
Background: Cardiovascular diseases are common cause of morbidity and mortality in patients with systemic connective tissue diseases (SCTD) due to accelerated atherosclerosis which couldn't be explained by traditional risk factors (CVDRF). Hypothesis: We hypothesized that recently developed score predicting probability of heart failure with preserved ejection fraction (H2FPEF), as well as a measure of right ventricular-pulmonary vasculature coupling [tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio], are predictive of atherosclerosis in SCTD. Methods: 203 patients (178 females) diagnosed with SCTD underwent standard and stress-echocardiography (SE) with TAPSE/PASP and left ventricular (LV) diastolic filling pressure (E/e') measurements, carotid ultrasound and computed tomographic coronary angiography. Patients who were SE positive for ischemia underwent coronary angiography (34/203). The H2FPEF score was calculated according to age, bod...y mass index, presence of atrial fibrillation, ≥2 antihypertensives, E/e' and PASP. Results: Mean LV ejection fraction was 66.3 ± 7.1%. Atherosclerosis was present in 150/203 patients according to: 1) intima-media thickness>0.9 mm; and 2) Agatstone score > 300 or Syntax score ≥ 1. On binary logistic regression analysis, including CVDRF prevalence, echocardiographic parameters and H2FPEF score, only H2FPEF score remained significant for the prediction of atherosclerosis presence (χ2 = 19.3, HR 2.6, CI 1.5-4.3, p < 0.001), and resting TAPSE/PASP for the prediction of a SE positive for ischemia (χ2 = 10.4, HR 0.01, CI = 0.01-0.22, p = 0.004). On ROC analysis, the optimal threshold value for identifying patients with atherosclerosis was a H2FPEF score ≥2 (Sn 60.4%, Sp 69.4%, area 0.67, SE = 0.05, p < 0.001). Conclusions: H2FPEF score and resting TAPSE/PASP demonstrated clinical value for an atherosclerosis diagnosis in patients diagnosed with SCTD.

Keywords:
coronary artery disease / H2FPEF score / right ventricular–pulmonary vasculature uncoupling / systemic connective tissue disease
Source:
Clinical Cardiology, 2021
Publisher:
  • Wiley Periodicals

DOI: 10.1002/clc.23621

ISSN: 0160-9289

WoS: 000656805100001

Scopus: 2-s2.0-85107407972
[ Google Scholar ]
1
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/3913
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Vasilev, Vladimir
AU  - Popović, Dejana
AU  - Ristić, Gorica
AU  - Arena, Ross
AU  - Radunović, Goran
AU  - Ristić, Arsen
PY  - 2021
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3913
AB  - Background: Cardiovascular diseases are common cause of morbidity and mortality in patients with systemic connective tissue diseases (SCTD) due to accelerated atherosclerosis which couldn't be explained by traditional risk factors (CVDRF). Hypothesis: We hypothesized that recently developed score predicting probability of heart failure with preserved ejection fraction (H2FPEF), as well as a measure of right ventricular-pulmonary vasculature coupling [tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio], are predictive of atherosclerosis in SCTD. Methods: 203 patients (178 females) diagnosed with SCTD underwent standard and stress-echocardiography (SE) with TAPSE/PASP and left ventricular (LV) diastolic filling pressure (E/e') measurements, carotid ultrasound and computed tomographic coronary angiography. Patients who were SE positive for ischemia underwent coronary angiography (34/203). The H2FPEF score was calculated according to age, body mass index, presence of atrial fibrillation, ≥2 antihypertensives, E/e' and PASP. Results: Mean LV ejection fraction was 66.3 ± 7.1%. Atherosclerosis was present in 150/203 patients according to: 1) intima-media thickness>0.9 mm; and 2) Agatstone score > 300 or Syntax score ≥ 1. On binary logistic regression analysis, including CVDRF prevalence, echocardiographic parameters and H2FPEF score, only H2FPEF score remained significant for the prediction of atherosclerosis presence (χ2 = 19.3, HR 2.6, CI 1.5-4.3, p < 0.001), and resting TAPSE/PASP for the prediction of a SE positive for ischemia (χ2 = 10.4, HR 0.01, CI = 0.01-0.22, p = 0.004). On ROC analysis, the optimal threshold value for identifying patients with atherosclerosis was a H2FPEF score ≥2 (Sn 60.4%, Sp 69.4%, area 0.67, SE = 0.05, p < 0.001). Conclusions: H2FPEF score and resting TAPSE/PASP demonstrated clinical value for an atherosclerosis diagnosis in patients diagnosed with SCTD.
PB  - Wiley Periodicals
T2  - Clinical Cardiology
T1  - H2FPEF score predicts atherosclerosis presence in patients
with systemic connective tissue disease
DO  - 10.1002/clc.23621
ER  - 
@article{
author = "Vasilev, Vladimir and Popović, Dejana and Ristić, Gorica and Arena, Ross and Radunović, Goran and Ristić, Arsen",
year = "2021",
abstract = "Background: Cardiovascular diseases are common cause of morbidity and mortality in patients with systemic connective tissue diseases (SCTD) due to accelerated atherosclerosis which couldn't be explained by traditional risk factors (CVDRF). Hypothesis: We hypothesized that recently developed score predicting probability of heart failure with preserved ejection fraction (H2FPEF), as well as a measure of right ventricular-pulmonary vasculature coupling [tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio], are predictive of atherosclerosis in SCTD. Methods: 203 patients (178 females) diagnosed with SCTD underwent standard and stress-echocardiography (SE) with TAPSE/PASP and left ventricular (LV) diastolic filling pressure (E/e') measurements, carotid ultrasound and computed tomographic coronary angiography. Patients who were SE positive for ischemia underwent coronary angiography (34/203). The H2FPEF score was calculated according to age, body mass index, presence of atrial fibrillation, ≥2 antihypertensives, E/e' and PASP. Results: Mean LV ejection fraction was 66.3 ± 7.1%. Atherosclerosis was present in 150/203 patients according to: 1) intima-media thickness>0.9 mm; and 2) Agatstone score > 300 or Syntax score ≥ 1. On binary logistic regression analysis, including CVDRF prevalence, echocardiographic parameters and H2FPEF score, only H2FPEF score remained significant for the prediction of atherosclerosis presence (χ2 = 19.3, HR 2.6, CI 1.5-4.3, p < 0.001), and resting TAPSE/PASP for the prediction of a SE positive for ischemia (χ2 = 10.4, HR 0.01, CI = 0.01-0.22, p = 0.004). On ROC analysis, the optimal threshold value for identifying patients with atherosclerosis was a H2FPEF score ≥2 (Sn 60.4%, Sp 69.4%, area 0.67, SE = 0.05, p < 0.001). Conclusions: H2FPEF score and resting TAPSE/PASP demonstrated clinical value for an atherosclerosis diagnosis in patients diagnosed with SCTD.",
publisher = "Wiley Periodicals",
journal = "Clinical Cardiology",
title = "H2FPEF score predicts atherosclerosis presence in patients
with systemic connective tissue disease",
doi = "10.1002/clc.23621"
}
Vasilev, V., Popović, D., Ristić, G., Arena, R., Radunović, G.,& Ristić, A.. (2021). H2FPEF score predicts atherosclerosis presence in patients
with systemic connective tissue disease. in Clinical Cardiology
Wiley Periodicals..
https://doi.org/10.1002/clc.23621
Vasilev V, Popović D, Ristić G, Arena R, Radunović G, Ristić A. H2FPEF score predicts atherosclerosis presence in patients
with systemic connective tissue disease. in Clinical Cardiology. 2021;.
doi:10.1002/clc.23621 .
Vasilev, Vladimir, Popović, Dejana, Ristić, Gorica, Arena, Ross, Radunović, Goran, Ristić, Arsen, "H2FPEF score predicts atherosclerosis presence in patients
with systemic connective tissue disease" in Clinical Cardiology (2021),
https://doi.org/10.1002/clc.23621 . .

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