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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Heart failure with preserved left ventricular ejection fraction in patients with acute myocardial infarction

Lucas Antonelli1, Marcelo Katz1, Fernando Bacal1

  • 1Hospital Israelita Albert Einstein, São Paulo, SP, BR.

Arquivos Brasileiros De Cardiologia
|June 4, 2015
PubMed

Insights

Heart failure with preserved ejection fraction after heart attack is common and significantly increases mortality risk. Patients with this condition require close monitoring due to elevated short-term death risk.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • The clinical outcomes and prevalence of heart failure with preserved left ventricular ejection fraction (HFpEF) following acute myocardial infarction (AMI) are not well understood.
  • Understanding HFpEF post-AMI is crucial for improving patient management and outcomes.

Purpose of the Study:

  • To determine the prevalence of HFpEF in patients admitted with AMI.
  • To investigate the association between HFpEF and in-hospital mortality after AMI.

Main Methods:

  • A prospective study included 1,474 patients with AMI.
  • Patients were categorized into three groups: no heart failure, HFpEF (Killip score > 1, LVEF ≥ 50%), and systolic dysfunction (Killip score > 1, LVEF < 50%).
  • Logistic regression models were used to assess the association between HFpEF and mortality, adjusted for key clinical factors.

Main Results:

  • Of the 1,474 patients, 5.3% had HFpEF, and 9.5% had systolic dysfunction.
  • Mortality rates were 4.3% for no heart failure, 17.9% for HFpEF, and 27.1% for systolic dysfunction (p < 0.001).
  • Adjusted analysis revealed HFpEF was associated with a 2.91-fold increased risk of in-hospital mortality (OR 2.91; 95% CI 1.35-6.27; p = 0.006).

Conclusions:

  • One-third of AMI patients with heart failure presented with preserved left ventricular ejection fraction.
  • While HFpEF patients had better outcomes than those with systolic dysfunction, they faced a significantly higher mortality risk compared to those without heart failure.
  • Patients with AMI and HFpEF experience elevated short-term mortality risk, necessitating specialized attention and monitoring during hospitalization.
Abstract

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