Heart Failure with Mid-Range Ejection Fraction in Patients Admitted for Acute Decompensation: A Report from the Japanese Multicenter Registry.
J Card Fail. 2019 May 23;:
Authors: Takei M, Kohsaka S, Shiraishi Y, Goda A, Nagatomo Y, Mizuno A, Suzino Y, Kohno T, Fukuda K, Yoshikawa T
BACKGROUND: Patients having heart failure with mid-range ejection fraction (HFmrEF: 40%≤EF<50%) are increasingly being considered a new subset of the heart-failure population. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. In addition, the significance of this new phenotype in hospitalized patients with acute decompensated heart failure (ADHF), another population whose prognosis has not improved, also remains poorly understood. This study aimed to describe the clinical characteristics, prognosis, and treatment responses of patients with HFmrEF hospitalized for ADHF.
METHODS: On the basis of consecutive inpatient data from a multicenter ADHF registry, 651/3572 patients (17.1%) were classified as having HFmrEF. Prognostic factors predicting composite outcomes, defined as all cause death and heart failure re-admission, as well as all-cause death alone were analyzed.
RESULTS: Within the median follow-up duration of 724 days, both composite endpoints and all-cause death alone were comparable among HFpEF, HFmrEF, and HFrEF. Age, anemia, hyponatremia, elevated blood urea nitrogen (BUN), chronic kidney disease (CKD), and elevated plasma brain natriuretic peptide (BNP) levels were significant predictors of composite outcomes in HFmrEF.
CONCLUSION: Roughly one-sixth of the ADHF patients had HFmrEF. Long-term prognosis of patients with HFmrEF was not significantly different from that of patients with HFpEF and HFrEF in the ADHF population. Risk factors for adverse outcomes in HFmrEF were also similar to those for HFpEF and HFmrEF in the hospitalized ADHF population.
PMID: 31129270 [PubMed - as supplied by publisher]