Heart failure & cardiomyopathiesSecondary analysis
Clinical Implications of Subclinical Left Ventricular Dysfunction in Heart Failure with Preserved Ejection Fraction: The PARAGON-HF Study
- Secondary analysis of the PARAGON-HF randomised trial
- echocardiography substudy
Authors' conclusion
In a large HFpEF population, impaired LV function was observed even among patients with preserved ejection fraction, and was associated with an increased risk of total HF hospitalizations or cardiovascular death, accounting for clinical confounders.
Study context
- Population
- Heart failure with preserved ejection fraction (HFpEF) patients with adequate image quality in the PARAGON-HF echocardiography study
- Participants
- 790 patients
- Comparison
- Worse vs better global longitudinal strain (GLS)
- Primary endpoint
- Total HF hospitalizations and CV death (composite)
- Follow-up
- Median 3.0 years
Primary result
Total HF hospitalizations and CV death · median 3.0 years
Adjusted hazard ratio
1.06
95% CI 1.02–1.11
P = 0.008
GLS per 1% decrease
adjusted HR 1.06 (95% CI 1.02–1.11); P = 0.008
Per 1% decrease, as printed
As reported in the abstract
- Total heart failure (HF) hospitalizations and CV deaths
- 407
Further findings
Left ventricular (LV) subclinical dysfunction (absolute GLS <16%)
- Prevalence (approximately)
- 47%
NT-proBNP · baseline
- Impaired GLS significantly associated with higher baseline NT-proBNP
Sacubitril/valsartan vs valsartan treatment effect by GLS
- GLS did not modify the treatment effect
- P for interaction > 0.1
- interaction P >0.1
Original publication
Clinical Implications of Subclinical Left Ventricular Dysfunction in Heart Failure with Preserved Ejection Fraction: The PARAGON-HF Study. Eur J Heart Fail. Published 18 February 2024. doi:10.1002/ejhf.3167
Summarised from the published abstract; every number is checked against it