Echocardiographic Parameters Associated with Bendopnea in Patients with Systolic Heart Failure

Alireza Rostamzadeh; Kamal Khademvatani; Shahyad Salehi; Mir Hossein Seyyed Mohammadzad; Mehdi Khani; Mojgan Hajahmadipour Rafsanjani; Behnam Askari; Behzad Rahimi; Zahra Mostafavi; Reza Hajizadeh

doi:10.18502/jthc.v17i4.11611

Alireza Rostamzadeh Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Kamal Khademvatani Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Shahyad Salehi Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Mir Hossein Seyyed Mohammadzad Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Mehdi Khani Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Mojgan Hajahmadipour Rafsanjani Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Behnam Askari Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Behzad Rahimi Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Zahra Mostafavi Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
Reza Hajizadeh Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.

DOI: https://doi.org/10.18502/jthc.v17i4.11611

Keywords: Heart failure; Bendopnea; Echocardiography; Right atrium

Abstract

Background: Bendopnea, defined as dyspnea while bending, can be observed in patients with heart failure (HF). In this study, we investigated the frequency of this symptom in patients with systolic HF and its association with echocardiographic parameters.

Methods: In this study, patients with left ventricular ejection fraction (LVEF) ≤45% and decompensated HF referred to our clinics were prospectively recruited. All the patients were examined by cardiologists for collecting data on the presence of bendopnea and baseline characteristics. They also underwent electrocardiographic and echocardiographic examinations. All findings were compared between the patients with or without bendopnea.

Results: A total of 120 patients at a mean age of 65.19±12.62 years were evaluated, and 74.8% were men. Bendopnea was observed in 44.2% of the patients. The etiology of HF was ischemic in most patients (81.9%), and the functional class of most patients (85.9%) was III or IV. The mortality rate at the 6-month follow-up was comparable between the patients with or without bendopnea (6.1% vs 9.5%; P=0.507). The waist circumference (odds ratio [OR], 1.037, 95% confidence interval [CI], 1.005 to 1.070; P=0.023), paroxysmal nocturnal dyspnea (OR, 0.338, 95% CI, 0.132 to 0.866; P=0.024), and right atrial size (OR, 1.084, 95% CI, 1.002 to 1.172; P=0.044) were associated with bendopnea.

Conclusion: Bendopnea can be frequently found among patients with systolic HF. This phenomenon is associated with obesity and baseline symptoms of patients and right atrial size upon echocardiographic examinations. It can help clinicians with the risk stratification of HF patients.