Ultrafiltration in Heart Failure with Preserved Ejection Fraction: Comparison with Systolic Heart Failure Patients.
Circ Heart Fail. 2013 Jun 4;
Authors: Jefferies JL, Bartone C, Menon S, Egnaczyk GF, O'Brien TM, Chung ES
Abstract
BACKGROUND: -Ultrafiltration (UF) is a widely used technology for inpatient management of acute decompensated heart failure (ADHF) in patients with volume overload. However, the safety and efficacy of UF in patients with heart failure and preserved left ventricular ejection fraction (LVEF, HFPEF) need further clarification. We hypothesized that UF could be used in this population with outcomes similar to ADHF patients with low LVEF (HFLEF). METHODS AND RESULTS: -Prospective evaluation was performed on two patient cohorts admitted to a single institution for ADHF and treated with UF: HFLEF (LVEF ≤ 40%, n=87) and HFPEF (LVEF > 40%, n=97). Selected demographic and clinical data were compared including clinical and serologic information as well as in-hospital and 90 day post discharge mortality. HFPEF patients were more likely to be female, have higher blood pressures, and less likely to have ischemic heart disease. There were no significant differences in total weight loss (7.7% in HFLEF and 7.0% in HFPEF), electrolyte and renal disturbances, or in-hospital mortality (3.4% in HFLEF and 3.3% in HFPEF) between the two groups. Mortality at 90 days tended to be greater in HELEF (24.1%) than in HFPEF (15.5%). CONCLUSIONS: -Therapeutic responses in patients with HFPEF meeting current indication for UF are similar to those with HFLEF Larger studies are warranted to better characterize acute HF management with UF in this population.
PMID: 23735537 [PubMed - as supplied by publisher]