Prognostic value of echocardiography and ECG in heart failure with preserved ejection fraction

The aim of this study was to evaluate characteristics of patients with heart failure (HF) with preserved ejection fraction (HFPEF) and to assess prognostic predictors in 2-year follow-up.

We included prospectively 109 patients admitted to the internal department for HF, grouped into HFPEF (EF>40 %, n = 63) and HF with reduced EF (HFREF) (EF≤40 %, n=46). Preserved right ventricular systolic function (PRV) was defined as the peak systolic tricuspid annular velocity (S') >10.8 cm/s.

HFPEF and HFREF patients had non-significantly different 2-year all-cause and CV mortality (28.6 % vs 37.0 %, 17.5 % vs 21.7 %). Patients with HFPEF and PRV vs dysfunctional RV had a better survival (76.6  % vs 56.3 %, p=0.045). In HFPEF, the patients who survived had a trend to better S' (13.6±3.1 cm/s vs 11.9±3.4 cm/s, p=0.055), shorter QTc (427±42ms vs 454±42ms, p=0.058), and all-cause mortality was lowered only by anticoagulants (12.0 % vs 39.5 %, p=0.02). QTc interval and PRV emerged as predictors of all-cause mortality (HR 1.7 per 40 ms change, 95  % CI 1.1-2.6, p = 0.02, HR 0.38, 95 % CI 0.15-0.93, p=0.03).

In HFPEF, we observed a trend to lower all-cause and CV mortality compared to HFREF and anticoagulants were the only therapy that significantly lowered mortality. PRV and QTc interval emerged as independent predictors of survival (Tab. 6, Fig. 2, Ref. 26).