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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.

Authors :
Chioncel, Ovidiu
Lainscak, Mitja
Seferovic, Petar M.
Anker, Stefan D.
Crespo-Leiro, Maria G.
Harjola, Veli-Pekka
Parissis, John
Laroche, Cecile
Piepoli, Massimo Francesco
Fonseca, Candida
Mebazaa, Alexandre
Lund, Lars
Ambrosio, Giuseppe A.
Coats, Andrew J.
Ferrari, Roberto
Ruschitzka, Frank
Maggioni, Aldo P.
Filippatos, Gerasimos
Source :
European Journal of Heart Failure. Supplements; Dec2017, Vol. 19 Issue 12, p1574-1585, 12p, 3 Charts, 5 Graphs
Publication Year :
2017

Abstract

AimsThe objectives of the present study were to describe epidemiology and outcomes in ambulatory heart failure (HF) patients stratified by left ventricular ejection fraction (LVEF) and to identify predictors for mortality at 1 year in each group. Methods and results The European Society of Cardiology Heart Failure Long-Term Registry is a prospective, observational study collecting epidemiological information and 1-year follow-up data in 9134 HF patients. Patients were classified according to baseline LVEF into HF with reduced EF [EF <40% (HFrEF)], mid-range EF [EF 40–50% (HFmrEF)] and preserved EF [EF >50% (HFpEF)]. In comparison with HFpEF subjects, patients with HFrEF were younger (64 years vs. 69 years), more commonly male (78% vs. 52%), more likely to have an ischaemic aetiology (49% vs. 24%) and left bundle branch block (24% vs. 9%), but less likely to have hypertension (56% vs. 67%) or atrial fibrillation (18% vs. 32%). The HFmrEF group resembled the HFrEF group in some features, including age, gender and ischaemic aetiology, but had less left ventricular and atrial dilation. Mortality at 1 year differed significantly between HFrEF and HFpEF (8.8% vs. 6.3%); HFmrEF patients experienced intermediate rates (7.6%). Age, New York Heart Association (NYHA) class III/IV status and chronic kidney disease predicted mortality in all LVEF groups. Low systolic blood pressure and high heart rate were predictors for mortality in HFrEF and HFmrEF. A lower body mass index was independently associated with mortality in HFrEF and HFpEF patients. Atrial fibrillation predicted mortality in HFpEF patients. Conclusions Heart failure patients stratified according to different categories of LVEF represent diverse phenotypes of demography, clinical presentation, aetiology and outcomes at 1 year. Differences in predictors for mortality might improve risk stratification and management goals. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
15674215
Volume :
19
Issue :
12
Database :
Complementary Index
Journal :
European Journal of Heart Failure. Supplements
Publication Type :
Academic Journal
Accession number :
127029797
Full Text :
https://doi.org/10.1002/ejhf.813