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How do patients with heart failure with preserved ejection fraction die?
Michelle M Y Chan1, Carolyn S P Lam
1Cardiovascular Research Institute, National University of Singapore, Singapore.
European Journal of Heart Failure
|April 24, 2013
Summary
Heart failure with preserved ejection fraction (HFPEF) has a substantial mortality rate, with cardiovascular causes dominating, though non-cardiovascular deaths are more prevalent than in HFREF.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- Heart failure with preserved ejection fraction (HFPEF) is a complex syndrome with significant mortality.
- Understanding HFPEF mortality is crucial for predicting treatment response and designing clinical trials.
Purpose of the Study:
- To review current knowledge on mortality rates, causes of death, and prognostic factors in HFPEF.
- To compare HFPEF mortality patterns with heart failure with reduced ejection fraction (HFREF).
Main Methods:
- Systematic review of existing literature on HFPEF mortality.
- Analysis of mortality rates, modes of death (cardiovascular vs. non-cardiovascular), and risk factors.
Main Results:
- HFPEF exhibits substantial annual mortality (10-30%), higher than controls but influenced by study type compared to HFREF.
- Cardiovascular deaths are the majority in HFPEF (51-70%), with sudden cardiac death and heart failure death being prominent.
- Non-cardiovascular deaths represent a larger proportion in HFPEF than in HFREF, potentially due to lower rates of coronary heart disease.
Conclusions:
- Mortality in HFPEF is significant, driven primarily by cardiovascular events.
- Differences in mortality patterns between HFPEF and HFREF exist, with a higher proportion of non-cardiovascular deaths in HFPEF.
- Age, gender, BMI, comorbidities, and coronary artery disease are key mortality risk factors in HFPEF.
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