Poor Olfaction and Risk of Heart Failure in the Atherosclerosis Risk in Communities Study.

Keran W Chamberlin, Chenxi Li, Anna Kucharska-Newton, Zhehui Luo, Mathew Reeves, Srishti Shrestha, Jayant M Pinto, Jennifer A Deal, Vidyulata Kamath, David Couper, Thomas H Mosley, Honglei Chen
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Abstract

Background: Poor olfaction may be associated with incident heart failure (HF) in older adults, but empirical evidence is scant.

Methods: We included 5,217 participants free of clinical HF and with a smell assessment in 2011-2013 from the Atherosclerosis Risk in Communities Study. Olfaction was measured by the 12-item Sniffin' Sticks odor identification test and defined as good (score 11-12), moderate (9-10), or poor (≤8). Participants were followed until the first HF hospitalization, death, last contact, or December 31, 2020, whichever happened first. We estimated adjusted risk ratios (aRR) for associations of olfaction with incident HF and its subtypes, and cross-sectional associations of olfaction with subclinical HF markers, including N-terminal pro-B-type natriuretic peptides (NT-proBNP), high-sensitive cardiac troponin T (hs-cTnT), and echocardiogram-defined structural heart disease.

Results: During a median 8.4-year follow-up, we identified 622 incident HF, including 212 with reduced ejection fraction (HFrEF) and 250 with preserved EF (HFpEF). Comparing poor with good olfaction, the aRR of HF was 1.24 (95% confidence interval (CI): 1.03,1.51) at year 8. Moderate olfaction showed a similar association pattern with HF risk, with the corresponding aRR of 1.23 (95% CI: 1.00,1.50). Poor olfaction appeared to have an evident association with HFrEF but not with HFpEF. Poor olfaction was associated with higher median levels of NT-proBNP and hs-cTnT, and higher odds of having structural heart disease than good olfaction.

Conclusions: In older adults, poor olfaction identified by a single smell test was associated with modestly higher risk of HF, especially HFrEF, and with known subclinical HF biomarkers.

社区动脉粥样硬化风险中嗅觉差和心力衰竭风险的研究
背景:嗅觉差可能与老年人心力衰竭(HF)的发生有关,但缺乏经验证据。方法:我们纳入了2011-2013年社区动脉粥样硬化风险研究中5217名无临床HF且嗅觉评估的参与者。通过12项嗅探棒气味识别测试来测量嗅觉,并将其定义为良好(11-12分)、中等(9-10分)或差(≤8分)。随访参与者直至首次HF住院、死亡、最后一次接触或2020年12月31日,以先发生者为准。我们估计了嗅觉与心衰事件及其亚型相关的调整风险比(aRR),以及嗅觉与亚临床心衰标志物的横断面关联,包括n端前b型利钠肽(NT-proBNP)、高敏感心肌肌钙蛋白T (hs-cTnT)和超声心动图定义的结构性心脏病。结果:在中位8.4年的随访中,我们确定了622例HF事件,包括212例射血分数降低(HFrEF)和250例保留EF (HFpEF)。与嗅觉差和嗅觉好相比,第8年HF的aRR为1.24(95%可信区间(CI): 1.03,1.51)。中度嗅觉与HF风险也有类似的关联模式,相应的aRR为1.23 (95% CI: 1.00,1.50)。嗅觉差似乎与HFrEF有明显的联系,但与HFpEF没有明显的联系。嗅觉差的人NT-proBNP和hs-cTnT的中位水平较高,患结构性心脏病的几率高于嗅觉好的人。结论:在老年人中,通过单一嗅觉测试确定的嗅觉差与HF(特别是HFrEF)的中度高风险相关,并与已知的亚临床HF生物标志物相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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