Clinical characteristics, one-year change in ejection fraction and long-term outcomes in patients with heart failure with mid-range ejection fraction : a multicentre prospective observational study in Catalonia (Spain)
Farré, Núria (Hospital del Mar (Barcelona, Catalunya))
Lupon, Josep (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Roig, Eulàlia (Institut d'Investigació Biomèdica Sant Pau)
Gonzalez-Costello, Jose (Institut d'Investigació Biomèdica de Bellvitge)
Vila-Domènech, Joan Salvador (Institut Hospital del Mar d'Investigacions Mèdiques)
Pérez, Silvia (Institut Hospital del Mar d'Investigacions Mèdiques)
de Antonio Ferrer, Marta (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Solé González, Eduard (Institut d'Investigació Biomèdica Sant Pau)
Sánchez-Enrique, Cristina (Institut d'Investigació Biomèdica de Bellvitge)
Moliner, Pedro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ruiz Bustillo, Sonia (Institut Hospital del Mar d'Investigacions Mèdiques)
Enjuanes, C.. (Universitat de Barcelona)
Mirabet Pérez, Sonia (Institut d'Investigació Biomèdica Sant Pau)
Bayés-Genís, Antoni (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Comín-Colet, Josep (Universitat de Barcelona)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	The aim of this study was to analyse baseline characteristics and outcome of patients with heart failure and mid-range left ventricular ejection fraction (HFmrEF, left ventricular ejection fraction (LVEF) 40%-49%) and the effect of 1-year change in LVEF in this group. Multicentre prospective observational study of ambulatory patients with HF followed up at four university hospitals with dedicated HF units. Fourteen per cent (n=504) of the 3580 patients included had HFmrEF. Baseline characteristics, 1-year LVEF and outcomes were collected. All-cause death, HF hospitalisation and the composite end-point were the primary outcomes. Median follow-up was 3. 66 (1. 69-6. 04) years. All-cause death, HF hospitalisation and the composite end-point were 47%, 35% and 59%, respectively. Outcomes were worse in HF with preserved ejection fraction (HFpEF) (LVEF>50%), without differences between HF with reduced ejection fraction (HFrEF) (LVEF<40%) and HFmrEF (all-cause mortality 52. 6% vs 45. 8% and 43. 8%, respectively, P=0. 001). After multivariable Cox regression analyses, no differences in all-cause death and the composite end-point were seen between the three groups. HF hospitalisation and cardiovascular death were not statistically different between patients with HFmrEF and HFrEF. At 1-year follow-up, 62% of patients with HFmrEF had LVEF measured: 24% had LVEF<40%, 43% maintained LVEF 40%-49% and 33% had LVEF>50%. While change in LVEF as continuous variable was not associated with better outcomes, those patients who evolved from HFmrEF to HFpEF did have a better outcome. Those who remained in the HFmrEF and HFrEF groups had higher all-cause mortality after adjustment for age, sex and baseline LVEF (HR 1. 96 (95% CI 1. 08 to 3. 54, P=0. 027) and HR 2. 01 (95% CI 1. 04 to 3. 86, P=0. 037), respectively). Patients with HFmrEF have a clinical profile in-between HFpEF and HFrEF, without differences in all-cause mortality and the composite end-point between the three groups. At 1 year, patients with HFmrEF exhibited the greatest variability in LVEF and this change was associated with survival.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Heart failure ; Echocardiography ; Ejection fraction ; Prognosis ; Recovered
Publicat a:	BMJ open, Vol. 7 (december 2017) , ISSN 2044-6055

DOI: 10.1136/bmjopen-2017-018719
PMID: 29273666

9 p, 699.4 KB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Articles > Articles de recerca
Articles > Articles publicats