Heart failure & cardiomyopathies

Clinical Implications of Subclinical Left Ventricular Dysfunction in Heart Failure with Preserved Ejection Fraction: The PARAGON-HF Study

Eur J Heart FailPublished Secondary analysis of the PARAGON-HF randomised trial

Primary result · Total HF hospitalizations and CV deathResult — go to the resultAdjusted hazard ratio 1.06 95% CI 1.02–1.11

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
Methodological detailsechocardiography substudy
  • Echocardiography substudy

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

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