Fate of Acute Heart Failure Patients With Mid-Range Ejection Fraction
Authors
Hye Bin Gwag ; Ga Yeon Lee ; Jin-Oh Choi ; Hae-Young Lee ; Jae-Joong Kim ; Kyung-Kuk Hwang ; Shung Chull Chae ; Sang Hong Baek ; Seok-Min Kang ; Dong-Ju Choi ; Byung-Su Yoo ; Kye Hun Kim ; Hyun-Young Park ; Myeong-Chan Cho ; Byung-Hee Oh ; Eun-Seok Jeon
Acute heart failure ; Heart failure with mid-range ejection fraction ; Left ventricular ejection fraction
Abstract
BACKGROUND: The outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) have been rarely studied, and follow-up data on left ventricular ejection fraction (LVEF) are scarse.Methods and Results:Patients were selected from a prospective multicenter registry of patients hospitalized for acute HF and then classified in the improved group if they exhibited %LVEF change ≥5 with follow-up LVEF ≥50%. Follow-up LVEF reported at least 90 days after discharge was used for classification. Of the 3,085 patients with acute HF, 454 were classified in the HFmrEF, and 276 had follow-up data. Of these 276 patients, 34.1% were classified in the improved group. Multivariate analysis revealed that hypertension, higher heart rate, lower serum sodium level, and maintenance therapy with β-blocker were associated with improved LVEF. The survival rate was significantly higher in the improved group than in the other groups. Young age and maintenance therapy with renin-angiotensin system blockers or aldosterone antagonists were significantly associated with better survival in HFmrEF.
CONCLUSIONS: One-third of HFmrEF patients showed improved LVEF; moreover, the survival rate in the improved group was higher than the other groups. Renin-angiotensin system blockers and aldosterone antagonists could improve the survival of HFmrEF patients.