Eur J Heart Fail. 2023 May 16. doi: 10.1002/ejhf.2895. Online ahead of print.
AIMS: We aimed to investigate the characteristics and prognosis of patients with heart failure with supra-normal ejection fraction (HFsnEF) compared to HF with normal EF (HFnEF).
METHODS AND RESULTS: Among 11,573 patients enrolled in the nationwide registry of hospitalized patients with HF in Japan, 1,943 patients (16.8%) were classified as HFsnEF (left ventricular EF [LVEF] > 65%), 3,277 (28.3%) as HFnEF (50% ≤ LVEF ≤ 65%), 2,024 (17.5%) as HF with mildly reduced EF (40% ≤ EF < 50%) and 4,329 (37.4%) as HF with reduced EF (LVEF < 40%). Patients with HFsnEF were older, more likely to be women, had lower natriuretic peptide values, and had smaller left ventricles than those with HFnEF. The primary endpoint, the composite of cardiovascular death or HF readmission, did not differ between HFsnEF (802/1943, 41.3%) and HFnEF (1413/3277, 43.1%) during a median follow-up period of 870 days (hazard ratio [HR] 0.96 [0.88-1.05], p = 0.346). The incidence of secondary outcomes, including all-cause, cardiovascular, and non-cardiovascular deaths and HF readmission, did not differ between HFsnEF and HFnEF. In the multivariable Cox regression analysis, HFsnEF compared to HFnEF was associated with a lower adjusted HR for HF readmission but not with the primary and other secondary endpoints. HFsnEF was associated with a higher HR for the composite endpoint and all-cause death in women, and a higher HR for all-cause death in patients with renal dysfunction.
CONCLUSIONS: HFsnEF is a common and distinctive phenotype, and has different characteristics and prognoses from HFnEF. This article is protected by copyright. All rights reserved.
PMID:37191180 | DOI:10.1002/ejhf.2895