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Differences in predictors of one-year mortality between patients with hypertensive and non-hypertensive acute heart failure: Usefulness of E/E′ in hypertensive heart failure

Published:November 02, 2016DOI:https://doi.org/10.1016/j.ejim.2016.10.018
      High blood pressure (BP) is an important factor causing acute decompensated heart failure (HF). An abrupt increase in BP has been associated with a surge in neurohormonal and cytokine activation, which is one of the triggers of acute decompensated HF and reported to induce redistribution of fluids from the systemic to pulmonary circulation, further neurohormonal activation, and increased left ventricular (LV) afterload [
      • Gheorghiade M.
      • Zannad F.
      • Sopko G.
      • Klein L.
      • Pina I.L.
      • Konstam M.A.
      • et al.
      Acute heart failure syndromes: current state and framework for future research.
      ]. On the other hand, long-standing hypertension leads to structural remodeling of the heart [
      • Santos M.
      • Shah A.M.
      Alterations in cardiac structure and function in hypertension.
      ,
      • Weber K.T.
      • Sun Y.
      • Guarda E.
      Structural remodeling in hypertensive heart disease and the role of hormones.
      ]. Although determinants of the LV functional and structural response to hypertension and interindividual variability thereof remain ill-defined [
      • Santos M.
      • Shah A.M.
      Alterations in cardiac structure and function in hypertension.
      ], patients with hypertensive HF (HTNHF) may show certain clinical characteristics that are distinct from those in patients with non-hypertensive HF (nonHTNHF), and the underlying pathophysiology can differ between these patient groups. Assessing the clinical characteristics and mechanisms of HTNHF is thus an important research topic from the viewpoint of individualized medicine. Accordingly, we compared the prognostic factors for one-year mortality between patients with hypertensive and non-hypertensive acute decompensated HF in the present study.

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