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Association of heart failure duration with clinical prognosis in advanced heart failure

Atsushi Sugiura1,2, Hideki Kitahara3, Togo Iwahana3

  • 1Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. sssugi@me.com.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|June 29, 2019
PubMed

Insights

Longer heart failure (HF) duration in advanced HF patients is linked to worse outcomes. This study found prolonged HF increases the risk of mortality, device implantation, and hospitalization.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Prognostic Biomarkers

Background:

  • Prognostic implications of heart failure (HF) duration in advanced HF remain unclear.
  • Understanding HF duration is crucial for managing advanced stages.

Purpose of the Study:

  • To investigate the prognostic impact of heart failure duration in advanced HF patients.
  • To determine the association between HF duration and adverse clinical outcomes.

Main Methods:

  • Prospective enrollment of 109 advanced HF patients referred for heart transplant evaluation.
  • Patients categorized into two groups based on HF duration: >18 months (n=38) and ≤18 months (n=71).
  • Cox proportional hazards model used to assess the association between HF duration and a 1-year composite endpoint (mortality, LVAD, HF hospitalization).

Main Results:

  • Longer HF duration correlated with older age, lower blood pressure, and larger left ventricular volume.
  • 1-year event-free survival was significantly lower in the longer HF duration group (49.1% vs. 80.0%, p<0.001).
  • Adjusted analysis revealed longer HF duration independently predicted increased risk for the composite endpoint (HR 2.44, p=0.04) and showed associations with myocardial damage markers.

Conclusions:

  • Prolonged heart failure duration is an independent predictor of adverse outcomes in advanced HF.
  • Longer HF duration is associated with more severe myocardial damage, indicated by imaging and scintigraphy.
  • These findings highlight the importance of HF duration as a prognostic factor in advanced HF management.
Abstract

Keywords:
Advanced heart failureDuration of diseaseMyocardial damagePrognosis

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