Clinical Characteristics and Long-Term Outcomes of Patients with Acute Decompensated Heart Failure with Mid-Range Ejection Fraction

Int Heart J. 2019 Jul 27;60(4):862-869. doi: 10.1536/ihj.18-631. Epub 2019 Jun 14.

Abstract

According to recent guidelines, a new category of patients with heart failure (HF) with mid-range left ventricular ejection fraction (LVEF) (HFmrEF) (LVEF = 40%-49%) has been defined. The purpose of this study was to investigate the clinical characteristics and long-term outcomes of patients with HFmrEF. This was a single-center, retrospective, observational study in which we examined the clinical characteristics and outcomes of 494 consecutive patients with acute decompensated heart failure who were admitted to our institution between January 2014 and December 2016. Of this population, 282 (57.1%), 75 (15.2%), and 137 (48.6%) patients had heart failure with reduced ejection fraction (HFrEF), HFmrEF, and heart failure with preserved ejection fraction (HFpEF), respectively. Ischemic heart disease was the primary etiology in HFmrEF and HFrEF. At the time of discharge, β-blockers and renin-angiotensin system inhibitors were more frequently prescribed in HFmrEF than in HFpEF. The composite outcome of cardiovascular mortality and HF readmission was significantly lower in HFmrEF than in HFrEF. Further studies are needed to determine the effectiveness of the management of coronary artery disease and cardioprotective medications for HFmrEF.

Keywords: Cardioprotective medication; Etiology; Heart failure with borderline ejection fraction; Prognosis.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease
  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Echocardiography / methods*
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis*
  • Heart Failure / drug therapy
  • Heart Failure / physiopathology
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Hospitalization / trends
  • Humans
  • Male
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Prognosis
  • Retrospective Studies
  • Stroke Volume / physiology*
  • Time Factors
  • Ventricular Function, Left / physiology*

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists