Pedal Edema as an Indicator of Early Heart Failure in the Community: Prevalence and Associations With Cardiac Structure/Function and Natriuretic Peptides (MESA [Multiethnic Study of Atherosclerosis]).

نویسندگان

  • Joseph Yeboah
  • Alain Bertoni
  • Waqas Qureshi
  • Shivani Aggarwal
  • Joao A C Lima
  • Nadine Kawel-Boehm
  • David A Bluemke
  • Sanjiv J Shah
چکیده

BACKGROUND The prevalence of pedal edema (PE) and its associations with abnormal cardiac structure/function, natriuretic peptides, and incident heart failure (HF) is unknown, especially in community-dwelling adults without a history of cardiovascular disease. METHODS AND RESULTS Out of 5004 MESA (Multiethnic Study of Atherosclerosis) participants who had cardiac magnetic resonance imaging, 4196 had complete data and were included in this analysis (3501 for the right ventricle analysis). Logistic regression and Cox proportional hazard analyses were used to assess the associations among self-reported PE, 2-pillow orthopnea, paroxysmal nocturnal dyspnea, left and right ventricular structure and function, natriuretic peptide levels, and incident HF. PE was present in 28% of the participants. PE was not associated with overt left or right ventricular systolic dysfunction (ejection fraction <50%). PE was associated with 2-pillow orthopnea (odds ratio 1.66; 95% confidence interval [CI], 1.30-2.12), paroxysmal nocturnal dyspnea (odds ratio 1.95; 95% CI, 1.55-2.44), and abnormal N-terminal pro-B-type natriuretic peptide levels (defined as >400 pg/mL; odds ratio 1.80; 95% CI, 1.21-2.68) in adjusted models. After a mean of 10.2 years of follow-up, 184/4196 (4.4%) participants had an adjudicated incident HF hospitalization. PE was associated with incident HF hospitalization in models adjusted for age, sex, and race (hazard ratio 1.44; 95% CI, 1.05-1.97). This association persisted after adding additional covariates, including comorbidities, baseline left ventricular ejection fraction, and antecedent myocardial infarction (hazard ratio 1.43; 95% CI, 1.02-1.99). The association of PE with incident HF was attenuated by further adjustment for N-terminal pro-B-type natriuretic peptide. CONCLUSIONS PE is prevalent in community-dwelling adults without clinically recognized cardiovascular disease and associated with future hospitalized HF.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Brain Natriuretic Peptides and Calcitonin Gene-Related Peptide in Diagnosis of Cardiac Involvement in Major Thalassemia Patients

Background: Cardiac dysfunction is one of the major causes of morbidity and mortality in thalassemia patients. This study aimed to compare the effect of Brain Natriuretic Peptides (BNP) and Calcitonin Gene-Related Peptide (CGRP) with echocardiographic findings in early diagnosis of cardiac disease in major thalassemia patients. Materials and Methods: This study was performed on 80 patients amo...

متن کامل

Diagnostic Value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP) in Cardiac Involvement in Patients with Beta- Thalassemia

Background Heart failure is a major cause of death in thalassemia. The study aimed to determine the diagnostic value of N Terminal Pro B Type Natriuretic Peptide (NT-pro BNP), to early diagnose the cardiac involvement in beta- thalassemia major patients. Materials and Methods  80 thalassemia patients aged 7 to 18 years old (patients group), and 80 healthy age and gender matched controls were ...

متن کامل

Evaluation of Brain Natriuretic Peptide plasma levels in children with Congenital Heart Diseases

ObjectiveThis study aimed to assess Brain Natriuretic Peptide in early diagnose of cardiac function in children with Congenital Heart Diseases.MethodologyThis study was performed on children with CHD and healthy. Severity of heart failure modified Ross classification system was used for grouping patients in four classes. For all participants, height, weight and head circumference were measured....

متن کامل

Clinical and Biochemical Assessments of Circulating B-Type Natriuretic Peptide as a Useful Marker in Pediatric Cardiac Patients

Background Although the left ventricle is the major site of BNP secretion in response to cardiac pressure or volume overload, the myocytes of both atria and ventricles secrete B- type natriuretic peptide (BNP). This study aimed to assess and compare the plasma levels of BNP in common pediatric cardiac diseases to clarify its pathophysiological role and evaluate its po...

متن کامل

Prevalence of Atherosclerotic Plaques in Autopsy Cases with Noncardiac Death

  Background and Objective: Ischemic heart disease (IHD) following atherosclerosis is the most common cause of cardiac deaths world wide. We aimed to investigate the pathologic features of atherosclerosis in non cardiac death cases to have an estimate of atherosclerosis prevalence in Mashad (North east of Iran). Patients and Methods : This descriptive (cross sectional) study was done, during ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation. Heart failure

دوره 9 12  شماره 

صفحات  -

تاریخ انتشار 2016