{'fraction_non_alphanumeric': 0.044744318181818184, 'fraction_numerical': 0.014204545454545454, 'mean_word_length': 5.463302752293578, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Impact of Afterload-Integrated Diastolic Index on Prognosis in Elderly Patients With Heart Failure With Preserved Ejection Fraction With and Without Atrial Fibrillation

Objects: We aimed to clarify the differences in the significance of the ratio of diastolic elastance (Ed) to arterial elastance (Ea), [Ed/ Ea=(E/e’)/(0.9×systolic blood pressure)], an afterload-integrated diastolic index that reflects left atrial pressure overload, on prognosis between patients with heart failure with preserved ejection fraction (HFpEF) with and without atrial fibrillation (AF). Methods: We studied 552 HFpEF patients hospitalized for acute decompensated heart failure (sinus rhythm/AF:352/200). Blood testing and transthoracic echocardiography were performed before discharge. Primary endpoint was all-cause mortality after discharge. Results: During a median follow-up of 508 days, 88 patients (sinus rhythm/AF: 54/34) had all-cause mortality. In the subgroup with sinus rhythm, but not AF, Ed/Ea was significantly higher in patients with than without all-cause mortality. In a multivariate Cox hazard analysis, Ed/ Ea was significantly associated with all-cause mortality independent of N-terminal pro-brain natriuretic peptide level in patients with sinus rhythm, but not with AF. Conclusions: Ed/Ea provided lesser important information for predicting all-cause mortality in HFpEF patients with AF than with sinus