Hye Bin Gwag1, Ga Yeon Lee1, Jin-Oh Choi1, Hae-Young Lee2, Jae-Joong Kim3, Kyung-Kuk Hwang4, Shung Chull Chae5, Sang Hong Baek6, Seok-Min Kang7, Dong-Ju Choi8, Byung-Su Yoo9, Kye Hun Kim10, Hyun-Young Park11, Myeong-Chan Cho4, Byung-Hee Oh2, Eun-Seok Jeon1. 1. Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine. 2. Department of Internal Medicine, Seoul National University Hospital. 3. University of Ulsan College of Medicine. 4. Chungbuk National University College of Medicine. 5. Kyungpook National University College of Medicine. 6. The Catholic University of Korea. 7. Yonsei University College of Medicine. 8. Seoul National University Bundang Hospital. 9. Yonsei University Wonju College of Medicine. 10. Heart Research Center of Chonnam National University. 11. National Institute of Health.
Abstract
BACKGROUND: The outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) have been rarely studied, and follow-up data on left ventricular ejection fraction (LVEF) are scarse.Methods and Results: Patients were selected from a prospective multicenter registry of patients hospitalized for acute HF and then classified in the improved group if they exhibited %LVEF change ≥5 with follow-up LVEF ≥50%. Follow-up LVEF reported at least 90 days after discharge was used for classification. Of the 3,085 patients with acute HF, 454 were classified in the HFmrEF, and 276 had follow-up data. Of these 276 patients, 34.1% were classified in the improved group. Multivariate analysis revealed that hypertension, higher heart rate, lower serum sodium level, and maintenance therapy with β-blocker were associated with improved LVEF. The survival rate was significantly higher in the improved group than in the other groups. Young age and maintenance therapy with renin-angiotensin system blockers or aldosterone antagonists were significantly associated with better survival in HFmrEF. CONCLUSIONS: One-third of HFmrEF patients showed improved LVEF; moreover, the survival rate in the improved group was higher than the other groups. Renin-angiotensin system blockers and aldosterone antagonists could improve the survival of HFmrEF patients.
BACKGROUND: The outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) have been rarely studied, and follow-up data on left ventricular ejection fraction (LVEF) are scarse.Methods and Results:Patients were selected from a prospective multicenter registry of patients hospitalized for acute HF and then classified in the improved group if they exhibited %LVEF change ≥5 with follow-up LVEF ≥50%. Follow-up LVEF reported at least 90 days after discharge was used for classification. Of the 3,085 patients with acute HF, 454 were classified in the HFmrEF, and 276 had follow-up data. Of these 276 patients, 34.1% were classified in the improved group. Multivariate analysis revealed that hypertension, higher heart rate, lower serum sodium level, and maintenance therapy with β-blocker were associated with improved LVEF. The survival rate was significantly higher in the improved group than in the other groups. Young age and maintenance therapy with renin-angiotensin system blockers or aldosterone antagonists were significantly associated with better survival in HFmrEF. CONCLUSIONS: One-third of HFmrEF patients showed improved LVEF; moreover, the survival rate in the improved group was higher than the other groups. Renin-angiotensin system blockers and aldosterone antagonists could improve the survival of HFmrEF patients.
Entities:
Keywords:
Acute heart failure; Heart failure with mid-range ejection fraction; Left ventricular ejection fraction