PhD ceremony Mr. V.M. van Deursen: Comorbidity in heart failure

PhD ceremony: Mr. V.M. van Deursen, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Comorbidity in heart failure

Promotor(s): prof. A.A. Voors, prof. D.J. van Veldhuisen

Faculty: Medical Sciences

Heart failure is a clinical syndrome characterised by the heart’s inability to meet the body’s circulatory demands. Patients with heart failure have a poor quality of life and high morbidity and mortality. In recent decades, growing evidence has accumulated about other diseases and dysfunction of other organs in patients with heart failure. These ‘co-morbidities’ frequently accompany heart failure and result in worse quality of life and clinical outcome.

In this thesis we aimed to assess (i) the prevalence of individual and multiple co-morbidities in patients with heart failure and whether the prevalence is higher than in age-matched controls, (ii) the pathophysiologic mechanisms connecting heart failure with individual co-morbidities as well as determinants of multiple co-morbidities, (iii) the prognostic influence of co-morbidities. We focussed on co-morbidities in general as well as renal and liver dysfunction separately. Patients with acute and chronic heart failure were both studied. In conclusion, co-morbidities frequently accompany heart failure and worsen morbidity and mortality. In accordance, the prevalence of co-morbidities is much higher in heart failure patients compared to an age-matched population. Although heart failure has a potential causal relation, the complex pathophysiological mechanisms remain unresolved. Next to known pathophysiological factors, our research shows ate hemodynamic factors (i.e. decreased cardiac output and raised central venous pressure) are important as well.