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Predictors and outcomes of heart failure with mid-range ejection fraction
Vijeta Bhambhani1,2, Jorge R Kizer3, Joao A C Lima4
1Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA.
European Journal of Heart Failure
|December 12, 2017
Summary
Heart failure with mid-range ejection fraction (HFmrEF) shares predictors with other heart failure types but has a worse mortality risk than HFpEF, similar to HFrEF.
Area of Science:
- Cardiology
- Epidemiology
- Biomarkers
Background:
- Heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF) are well-defined.
- Determinants and outcomes of heart failure with mid-range ejection fraction (HFmrEF) remain unclear.
Purpose of the Study:
- To examine clinical and biochemical predictors of incident HFmrEF in the community.
- To compare mortality risk associated with HFmrEF to HFpEF and HFrEF.
Main Methods:
- Pooled data from four community-based longitudinal cohorts.
- Classified new heart failure (HF) into HFmrEF (EF 41-49%), HFpEF (EF ≥50%), and HFrEF (EF ≤40%).
- Assessed predictors using multivariable Cox models.
Main Results:
- Identified clinical predictors of HFmrEF: age, male sex, systolic blood pressure, diabetes, and prior myocardial infarction.
- Identified biochemical predictors: natriuretic peptides, cystatin-C, and high-sensitivity troponin.
- Mortality after HFmrEF was higher than HFpEF but similar to HFrEF.
Conclusions:
- HFmrEF shares predictors with other HF subtypes.
- Mortality risk following HFmrEF is significantly worse than HFpEF and comparable to HFrEF.
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