| dc.contributor.author | Sigurjónsdóttir, Rúna | |
| dc.date.accessioned | 2016-11-01T14:02:54Z | |
| dc.date.available | 2016-11-01T14:02:54Z | |
| dc.date.issued | 2016-11-01 | |
| dc.identifier.isbn | 978-91-628-9941-7 (PDF) | |
| dc.identifier.isbn | 978-91-628-9942-4 (PRINT) | |
| dc.identifier.uri | http://hdl.handle.net/2077/44859 | |
| dc.description.abstract | Background: Heart failure has high morbidity and mortality and the incidence increases with
age. Most randomized studies in heart failure were conducted in younger heart failure patients,
despite the fact that the majority of the heart failure population is elderly. Therefore, the clinical
phenotype and prognosis in elderly heart failure patients have been inadequately studied.
Aims: To characterize the clinical phenotype and study the prognosis of the elderly heart failure
population, with focus on co-morbidities and biomarkers in three main categories of heart
failure: heart failure with reduced ejection fraction (HFrEF), HF with preserved ejection
fraction (HFpEF) and post-infarction HF.
Methods: This thesis comprises four parts: 1) a retrospective study on differences in clinical
phenotype between the younger and older heart failure populations and between different heart
failure categories in 24236 patients by accessing The Swedish Heart Failure Registry; 2) a
prospective study on the correlation between red cell distribution width (RDW) and cardiac
function between different heart failure categories in 296 patients referred for echocardiography;
3) a prospective study of 138 elderly acute coronary syndrome (ACS) patients, on prognosis in
terms of major adverse cardiovascular events (MACE), including post-ACS heart failure and
quality of life during a 3 year follow-up; 4) a retrospective study of 494 patients on all cause
mortality and factors influencing mortality in different heart failure categories after 5 years of
follow-up.
Results: When compared to the younger heart failure population, the elderly heart failure
population had more co-morbidities and more often HFpEF, in addition they received less lifesaving
therapy. Mortality rates increased with age and were higher for HFrEF than HFpEF.
Moreover, prognostic factors varied between different categories of heart failure. In spite of
advanced treatment of ACS patients, post-ACS heart failure was still common and was coupled
with worse quality of life.
Conclusion: Heart failure in the elderly is a unique clinical entity, not only when it comes to
clinical characteristics but also in prognosis and its influencing factors. In the elderly, comorbidities
not only more often accompany heart failure but also affect the clinical phenotype
and prognosis and therefore co-morbidities should be regarded as an important part of heart
failure. | sv |
| dc.language.iso | eng | sv |
| dc.relation.haspart | Holmström A, Sigurjonsdottir R, Edner M, Jonsson A, Dahlström U, Fu ML.
Increased comorbidities in heart failure patients ≥ 85 years but declined from
>90 years: data from the Swedish Heart Failure Registry. Int J Cardiol. 2013 Sep
10;167(6):2747-52. ::doi::10.1016/j.ijcard.2012.06.095 | sv |
| dc.relation.haspart | Holmström A, Sigurjonsdottir R, Hammarsten O, Gustafsson D, Petzold M, Fu ML.
Red blood cell distribution width and its relation to cardiac function and
biomarkers in a prospective hospital cohort referred for echocardiography. Eur J
Intern Med. 2012 Oct;23(7):604-9. ::doi::10.1016/j.ejim.2012.05.005 | sv |
| dc.relation.haspart | Sigurjonsdottir R, Barywani S, Albertsson P, Fu M. Long-term major adverse
cardiovascular events and quality of life after coronary angiography in elderly
patients with acute coronary syndrome. Int J Cardiol. 2016 Nov 1;222:481-5. ::doi::10.1016/j.ijcard.2016.07.237 | sv |
| dc.relation.haspart | Sigurjonsdottir R, Kontogeorgos S, Johansson M, Albertsson P, Fu M.
Long term outcome and influencing factors in different categories of heart failure in
the elderly. In manuscript | sv |
| dc.subject | Heart failure | sv |
| dc.subject | Elderly | sv |
| dc.subject | Co-morbidities | sv |
| dc.subject | prognosis | sv |
| dc.title | Heart failure in the elderly: clinical phenotype, prognosis and influencing factors | sv |
| dc.type | text | eng |
| dc.type.svep | Doctoral thesis | eng |
| dc.gup.mail | runa.sigurjonsdottir@vgregion.se | sv |
| dc.type.degree | Doctor of Philosophy (Medicine) | sv |
| dc.gup.origin | University of Gothenburg. Sahlgrenska Academy | sv |
| dc.gup.department | Institute of Medicine. Department of Molecular and Clinical Medicine | sv |
| dc.gup.defenceplace | Fredagen den 18 november 2016, kl 9.00, Arvid Carlsson hörsal, Academicum, Medicinaregatan 3, Göteborg | sv |
| dc.gup.defencedate | 2016-11-18 | |
| dc.gup.dissdb-fakultet | SA | |
