Prognostic impact of prior LVEF in patients with heart failure with mildly reduced ejection fraction.
HFmrEF
Heart failure with mildly reduced ejection fraction
LVEF
Mortality, longitudinal changes of LVEF
Prognosis
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
15 Apr 2024
15 Apr 2024
Historique:
received:
05
01
2024
accepted:
25
03
2024
medline:
15
4
2024
pubmed:
15
4
2024
entrez:
15
4
2024
Statut:
aheadofprint
Résumé
As there is limited evidence regarding the prognostic impact of prior left ventricular ejection fraction (LVEF) in patients with heart failure with mildly reduced ejection fraction (HFmrEF), this study investigates the prognostic impact of longitudinal changes in LVEF in patients with HFmrEF. Consecutive patients with HFmrEF (i.e. LVEF 41-49% with signs and/or symptoms of HF) were included retrospectively in a monocentric registry from 2016 to 2022. Based on prior LVEF, patients were categorized into three groups: stable LVEF, improved LVEF, and deteriorated LVEF. The primary endpoint was 30-months all-cause mortality (median follow-up). Secondary endpoints included in-hospital and 12-months all-cause mortality, as well as HF-related rehospitalization at 12 and 30 months. Kaplan-Meier and multivariable Cox proportional regression analyses were applied for statistics. Six hundred eighty-nine patients with HFmrEF were included. Compared to their prior LVEF, 24%, 12%, and 64% had stable, improved, and deteriorated LVEF, respectively. None of the three LVEF groups was associated with all-cause mortality at 12 (p ≥ 0.583) and 30 months (31% vs. 37% vs. 34%; log rank p ≥ 0.376). In addition, similar rates of 12- (p ≥ 0.533) and 30-months HF-related rehospitalization (21% vs. 23% vs. 21%; log rank p ≥ 0.749) were observed. These findings were confirmed in multivariable regression analyses in the entire study cohort. The transition from HFrEF and HFpEF towards HFmrEF is very common. However, prior LVEF was not associated with prognosis, likely due to the persistently high dynamic nature of LVEF in the follow-up period.
Identifiants
pubmed: 38619579
doi: 10.1007/s00392-024-02443-0
pii: 10.1007/s00392-024-02443-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Roger VL (2021) Epidemiology of heart failure: a contemporary perspective. Circ Res 128(10):1421–1434. https://doi.org/10.1161/circresaha.121.318172
doi: 10.1161/circresaha.121.318172
pubmed: 33983838
Bragazzi NL, Zhong W, Shu J, Abu Much A, Lotan D, Grupper A et al (2021) Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017. Eur J Prev Cardiol 28(15):1682–1690. https://doi.org/10.1093/eurjpc/zwaa147
doi: 10.1093/eurjpc/zwaa147
pubmed: 33571994
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC et al (2013) Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail 6(3):606–619. https://doi.org/10.1161/HHF.0b013e318291329a
doi: 10.1161/HHF.0b013e318291329a
pubmed: 23616602
pmcid: 3908895
James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N et al (2018) Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392(10159):1789–858. https://doi.org/10.1016/s0140-6736(18)32279-7
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al (2021) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368
doi: 10.1093/eurheartj/ehab368
pubmed: 34447992
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM et al (2022) 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 145(18):e895–e1032. https://doi.org/10.1161/CIR.0000000000001063
doi: 10.1161/CIR.0000000000001063
pubmed: 35363499
Chioncel O, Lainscak M, Seferovic PM, Anker SD, Crespo-Leiro MG, Harjola VP et al (2017) Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 19(12):1574–1585. https://doi.org/10.1002/ejhf.813
doi: 10.1002/ejhf.813
pubmed: 28386917
Koh AS, Tay WT, Teng THK, Vedin O, Benson L, Dahlstrom U et al (2017) A comprehensive population-based characterization of heart failure with mid-range ejection fraction. Eur J Heart Fail 19(12):1624–1634. https://doi.org/10.1002/ejhf.945
doi: 10.1002/ejhf.945
pubmed: 28948683
Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N et al (2021) Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail 23(3):352–380. https://doi.org/10.1002/ejhf.2115
doi: 10.1002/ejhf.2115
pubmed: 33605000
Angaran P, Dorian P, Ha ACT, Thavendiranathan P, Tsang W, Leong-Poi H et al (2020) Association of left ventricular ejection fraction with mortality and hospitalizations. J Am Soc Echocardiogr 33(7):802–11.e6. https://doi.org/10.1016/j.echo.2019.12.016
doi: 10.1016/j.echo.2019.12.016
pubmed: 32164977
Lupón J, Díez-López C, de Antonio M, Domingo M, Zamora E, Moliner P et al (2017) Recovered heart failure with reduced ejection fraction and outcomes: a prospective study. Eur J Heart Fail 19(12):1615–1623. https://doi.org/10.1002/ejhf.824
doi: 10.1002/ejhf.824
pubmed: 28387002
He Y, Ling Y, Guo W, Li Q, Yu S, Huang H et al (2021) Prevalence and prognosis of HFimpEF developed from patients with heart failure with reduced ejection fraction: systematic review and meta-analysis. Front Cardiovasc Med 8:757596. https://doi.org/10.3389/fcvm.2021.757596
doi: 10.3389/fcvm.2021.757596
pubmed: 34901217
pmcid: 8655693
Kalogeropoulos AP, Kim S, Rawal S, Jadonath A, Tangutoori R, Georgiopoulou V (2019) Serial changes in left ventricular ejection fraction and outcomes in outpatients with heart failure and preserved ejection fraction. Am J Cardiol 124(5):729–735. https://doi.org/10.1016/j.amjcard.2019.05.052
doi: 10.1016/j.amjcard.2019.05.052
pubmed: 31272702
Okuhara Y, Asakura M, Orihara Y, Morisawa D, Matsumoto Y, Naito Y et al (2019) Reduction in left ventricular ejection fraction is associated with subsequent cardiac events in outpatients with chronic heart failure. Sci Rep 9(1):17271. https://doi.org/10.1038/s41598-019-53697-y
doi: 10.1038/s41598-019-53697-y
pubmed: 31754155
pmcid: 6872762
Savarese G, Vedin O, D’Amario D, Uijl A, Dahlström U, Rosano G et al (2019) Prevalence and prognostic implications of longitudinal ejection fraction change in heart failure. JACC Heart Fail 7(4):306–317. https://doi.org/10.1016/j.jchf.2018.11.019
doi: 10.1016/j.jchf.2018.11.019
pubmed: 30852236
Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ et al (2003) Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet 362(9386):777–781. https://doi.org/10.1016/s0140-6736(03)14285-7
doi: 10.1016/s0140-6736(03)14285-7
pubmed: 13678871
Pitt B, Pfeffer MA, Assmann SF, Boineau R, Anand IS, Claggett B et al (2014) Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 370(15):1383–1392. https://doi.org/10.1056/NEJMoa1313731
doi: 10.1056/NEJMoa1313731
pubmed: 24716680
Solomon SD, McMurray JJV, Anand IS, Ge J, Lam CSP, Maggioni AP et al (2019) Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med 381(17):1609–1620. https://doi.org/10.1056/NEJMoa1908655
doi: 10.1056/NEJMoa1908655
pubmed: 31475794
Schmitt A, Schupp T, Reinhardt M, Abel N, Lau F, Forner J et al (2023) Prognostic impact of acute decompensated heart failure in patients with heart failure with mildly reduced ejection fraction. Eur Heart J Acute Cardiovasc Care 13(2):225–241. https://doi.org/10.1093/ehjacc/zuad139
doi: 10.1093/ehjacc/zuad139
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al (2021) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368
doi: 10.1093/eurheartj/ehab368
pubmed: 34447992
Popescu BA, Andrade MJ, Badano LP, Fox KF, Flachskampf FA, Lancellotti P et al (2009) European Association of Echocardiography recommendations for training, competence, and quality improvement in echocardiography. Eur J Echocardiogr 10(8):893–905. https://doi.org/10.1093/ejechocard/jep151
doi: 10.1093/ejechocard/jep151
pubmed: 19889658
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16(3):233–270. https://doi.org/10.1093/ehjci/jev014
doi: 10.1093/ehjci/jev014
pubmed: 25712077
Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P et al (2008) Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 29(2):270–276. https://doi.org/10.1093/eurheartj/ehm342
doi: 10.1093/eurheartj/ehm342
pubmed: 17916581
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al (2018) 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J 39(33):3021–3104. https://doi.org/10.1093/eurheartj/ehy339
doi: 10.1093/eurheartj/ehy339
pubmed: 30165516
Lancellotti P, Tribouilloy C, Hagendorff A, Popescu BA, Edvardsen T, Pierard LA et al (2013) Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14(7):611–644. https://doi.org/10.1093/ehjci/jet105
doi: 10.1093/ehjci/jet105
pubmed: 23733442
Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J et al (2021) 2021 ESC/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 43(7):561–632. https://doi.org/10.1093/eurheartj/ehab395
doi: 10.1093/eurheartj/ehab395
Gopinathannair R, Etheridge SP, Marchlinski FE, Spinale FG, Lakkireddy D, Olshansky B (2015) Arrhythmia-induced cardiomyopathies: mechanisms, recognition, and management. J Am Coll Cardiol 66(15):1714–1728
doi: 10.1016/j.jacc.2015.08.038
pubmed: 26449143
pmcid: 4733572
Kaye G, Ng JY, Ahmed S, Valencia D, Harrop D, Ng ACT (2019) The prevalence of pacing-induced cardiomyopathy (PICM) in patients with long term right ventricular pacing - is it a matter of definition? Heart Lung Circ 28(7):1027–1033. https://doi.org/10.1016/j.hlc.2018.05.196
doi: 10.1016/j.hlc.2018.05.196
pubmed: 30017634
Tsuji K, Sakata Y, Nochioka K, Miura M, Yamauchi T, Onose T et al (2017) Characterization of heart failure patients with mid-range left ventricular ejection fraction—a report from the CHART-2 Study. Eur J Heart Fail 19(10):1258–1269. https://doi.org/10.1002/ejhf.807
doi: 10.1002/ejhf.807
pubmed: 28370829
Rickenbacher P, Kaufmann BA, Maeder MT, Bernheim A, Goetschalckx K, Pfister O et al (2017) Heart failure with mid-range ejection fraction: a distinct clinical entity? Insights from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF). Eur J Heart Fail 19(12):1586–1596. https://doi.org/10.1002/ejhf.798
doi: 10.1002/ejhf.798
pubmed: 28295985
Farmakis D, Simitsis P, Bistola V, Triposkiadis F, Ikonomidis I, Katsanos S et al (2017) Acute heart failure with mid-range left ventricular ejection fraction: clinical profile, in-hospital management, and short-term outcome. Clin Res Cardiol 106(5):359–368. https://doi.org/10.1007/s00392-016-1063-0
doi: 10.1007/s00392-016-1063-0
pubmed: 27999929
Zhou Q, Li P, Zhao H, Xu X, Li S, Zhao J et al (2021) Heart failure with mid-range ejection fraction: a distinctive subtype or a transitional stage? Front Cardiovasc Med 8:678121. https://doi.org/10.3389/fcvm.2021.678121
doi: 10.3389/fcvm.2021.678121
pubmed: 34113665
pmcid: 8185203
Lee DS, Gona P, Vasan RS, Larson MG, Benjamin EJ, Wang TJ et al (2009) Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the framingham heart study of the national heart, lung, and blood institute. Circulation 119(24):3070–3077. https://doi.org/10.1161/circulationaha.108.815944
doi: 10.1161/circulationaha.108.815944
pubmed: 19506115
pmcid: 2775498
Tsukamoto K, Suzuki A, Shiga T, Arai K, Hagiwara N (2021) Changes in the left ventricular ejection fraction and outcomes in hospitalized heart failure patients with mid-range ejection fraction: a prospective observational study. Intern Med 60(10):1509–1518. https://doi.org/10.2169/internalmedicine.6388-20
doi: 10.2169/internalmedicine.6388-20
pubmed: 33328410
Pecini R, Møller DV, Torp-Pedersen C, Hassager C, Køber L (2011) Heart failure etiology impacts survival of patients with heart failure. Int J Cardiol 149(2):211–215. https://doi.org/10.1016/j.ijcard.2010.01.011
doi: 10.1016/j.ijcard.2010.01.011
pubmed: 20193969
Shore S, Grau-Sepulveda MV, Bhatt DL, Heidenreich PA, Eapen ZJ, Hernandez AF et al (2015) Characteristics, treatments, and outcomes of hospitalized heart failure patients stratified by etiologies of cardiomyopathy. JACC Heart Fail 3(11):906–916. https://doi.org/10.1016/j.jchf.2015.06.012
doi: 10.1016/j.jchf.2015.06.012
pubmed: 26454848
Chioncel O, Mebazaa A, Harjola VP, Coats AJ, Piepoli MF, Crespo-Leiro MG et al (2017) Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 19(10):1242–1254. https://doi.org/10.1002/ejhf.890
doi: 10.1002/ejhf.890
pubmed: 28463462
Yamamoto M, Seo Y, Ishizu T, Nishi I, Hamada-Harimura Y, Machino-Ohtsuka T et al (2019) Different impact of changes in left ventricular ejection fraction between heart failure classifications in patients with acute decompensated heart failure. Circ J 83(3):584–594. https://doi.org/10.1253/circj.CJ-18-0881
doi: 10.1253/circj.CJ-18-0881
pubmed: 30674752
Brann A, Janvanishstaporn S, Greenberg B (2020) Association of prior left ventricular ejection fraction with clinical outcomes in patients with heart failure with midrange ejection fraction. JAMA Cardiol 5(9):1027–1035. https://doi.org/10.1001/jamacardio.2020.2081
doi: 10.1001/jamacardio.2020.2081
pubmed: 32936274
Zhang X, Sun Y, Zhang Y, Chen F, Zhang S, He H et al (2021) Heart failure with midrange ejection fraction: prior left ventricular ejection fraction and prognosis. Front Cardiovasc Med 8:697221. https://doi.org/10.3389/fcvm.2021.697221
doi: 10.3389/fcvm.2021.697221
pubmed: 34409076
pmcid: 8364975
Marwick TH (2018) Ejection fraction pros and cons: JACC state-of-the-art review. J Am Coll Cardiol 72(19):2360–2379. https://doi.org/10.1016/j.jacc.2018.08.2162
doi: 10.1016/j.jacc.2018.08.2162
pubmed: 30384893
Mann DL (2016) Is it time for a new taxonomy for heart failure? J Card Fail 22(9):710–712. https://doi.org/10.1016/j.cardfail.2016.07.432
doi: 10.1016/j.cardfail.2016.07.432
pubmed: 27427221
Lupón J, Bayés-Genís A (2018) Left ventricular ejection fraction in heart failure: a clinician’s perspective about a dynamic and imperfect parameter, though still convenient and a cornerstone for patient classification and management. Eur J Heart Fail 20(3):433–435. https://doi.org/10.1002/ejhf.1116
doi: 10.1002/ejhf.1116
pubmed: 29251402
Wood PW, Choy JB, Nanda NC, Becher H (2014) Left ventricular ejection fraction and volumes: it depends on the imaging method. Echocardiography 31(1):87–100. https://doi.org/10.1111/echo.12331
doi: 10.1111/echo.12331
pubmed: 24786629
Barbier P, Mirea O, Cefalù C, Maltagliati A, Savioli G, Guglielmo M (2015) Reliability and feasibility of longitudinal AFI global and segmental strain compared with 2D left ventricular volumes and ejection fraction: intra- and inter-operator, test-retest, and inter-cycle reproducibility. Eur Heart J Cardiovasc Imaging 16(6):642–652. https://doi.org/10.1093/ehjci/jeu274
doi: 10.1093/ehjci/jeu274
pubmed: 25564395
Kosaraju A, Goyal A, Grigorova Y, Makaryus AN (2022) Left ventricular ejection fraction. StatPearls. StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC, Treasure Island (FL)
Stanton T, Leano R, Marwick TH (2009) Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging 2(5):356–364. https://doi.org/10.1161/circimaging.109.862334
doi: 10.1161/circimaging.109.862334
pubmed: 19808623
Triposkiadis F, Butler J, Abboud FM, Armstrong PW, Adamopoulos S, Atherton JJ et al (2019) The continuous heart failure spectrum: moving beyond an ejection fraction classification. Eur Heart J 40(26):2155–2163. https://doi.org/10.1093/eurheartj/ehz158
doi: 10.1093/eurheartj/ehz158
pubmed: 30957868
pmcid: 7963129