Differential Prognostic Impact of Clinical Congestion between Preserved versus Reduced Ejection Fraction in Patients Hospitalized for Acute Decompensated Heart Failure: Findings from the Japanese KCHF registry.

BACKGROUNDS

Most patients hospitalized for heart failure (HF) present with signs of congestion. Prognostic significance of clinical congestion may vary depending on left ventricular ejection fraction (LVEF). This study aims to investigate the prognostic impact of congestion across different LVEF categories.

METHODS AND RESULTS

Composite congestion scores (CCS) (0-9) derived from the severity of edema, jugular venous pressure, and orthopnea, were analyzed on admission and at discharge in 3787 patients hospitalized for HF (LVEF≥40%: n=2347, LVEF<40%: n=1440). The median admission CCS was 4 in both LVEF strata (P=0.64). Adjusted HRs (95%CI) of the moderate [CCS 4-6] and severe congestion [7-9] groups relative to the mild congestion [0-3] group on admission for a composite of all-cause death or HF re-hospitalization were 1.20 (1.04-1.39, P=0.01) and 1.54 (1.27-1.86, P<0.001) in the LVEF≥40% stratum, and 1.20 (1.01-1.44, P=0.04) and 0.82 (0.61-1.07, P=0.14) in the LVEF<40% stratum, respectively (P

CONCLUSION

The severity of clinical congestion on admission was associated with adverse clinical outcomes in patients with LVEF ≥40%, but no in those with LVEF <40%. These findings warrant further studies to better understand the detailed profile of congestion across the LVEF spectrum.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.