After accounting for the clinical risk score, several echocardiographic findings were independently associated with incident heart failure HRs 1.11 to 2.91, P≤0.001 for all:
- Reduced left ventricular ejection fraction
- Abnormal mitral inflow E/A peak velocity ratio a measure of diastolic function
- Enlarged left atrium Increased left ventricular mass
These variables were used to create an echocardiographic score.Elevated levels of NT-proBNP also were independently associated with heart failure risk HR 1.61 as a continuous variable and HR 2.7 for values greater than 190 pg/mL, P
CHF
GDF-15 Predicts Mortality
LAVI
…it makes intuitive sense that LA enlargement, as a nonspecific marker of high LV diastolic pressure due to any cause, is a marker of adverse prognosis.
NT-proBNP – Find It, Post It
Here is a pretty good article on NT-proBNP.
Read it after you watch the video on giant killer squids.
Another Fascinating U Shaped Mortality Curve
To look farther down the disease spectrum than the analysis in ACCORD, Dr. Aguilar’s group retrospectively examined outcomes for a national cohort of 5,815 ambulatory diabetic patients with established heart failure who were treated in ambulatory clinics at VA medical centers.
During two years of follow-up, mortality rates were:
* 25.0% in the bottom quintile with hemoglobin A1c levels of 6.4% or less.
* 23.0% in the group with A1c levels of 6.5% to 7.1%.
* 17.7% in the middle quintile with glycosylated hemoglobin levels above 7.1% but no more than 7.8%.
* 22.5% in the group with A1c levels of 7.9% to 9.0%.
* 23.2% in the top quartile with hemoglobin A1c levels above 9.0%.
This is must-have information for all the life settlement underwriters out there.
Diet, Lifestyle, and CHF
Male physicians who adhered to at least four of six healthy lifestyle factors — normal weight, abstinence from smoking, regular exercise, moderate alcohol intake, and consumption of breakfast cereals and fruits and vegetables — had a lower risk of heart failure, the study found.
CHF + Anemia = 66% Higher Mortality Risk
Interesting study without much practical application if you are a mortality risk underwriter.
Interesting study with some practical use if you are a life expectancy underwriter.
lifeunderwriter.net 