Related Experiment Video
Updated: Dec 27, 2025
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Temporal changes in left ventricular ejection fraction and their prognostic impacts in patients with Stage B heart
Hajime Aoyanagi1, Kotaro Nochioka2, Yasuhiko Sakata2
1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan.
Insights
Left ventricular ejection fraction (LVEF) dynamically changes in asymptomatic Stage B heart failure patients, similar to Stage C/D patients. These LVEF changes have prognostic impacts, though determination factors may differ between stages.
Area of Science:
- Cardiology
- Heart Failure Research
- Clinical Cardiology
Background:
- Left ventricular ejection fraction (LVEF) dynamically changes over time with prognostic impacts in Stage C/D heart failure (HF) patients.
- It remains unknown if similar dynamic LVEF changes occur in asymptomatic Stage B patients, who are at risk for HF but have no prior history.
Purpose of the Study:
- To investigate the dynamic changes in LVEF over time in asymptomatic Stage B heart failure patients.
- To determine the prognostic impacts of these LVEF transitions in Stage B patients.
- To compare LVEF dynamics and their determinants between Stage B and Stage C/D heart failure patients.
Main Methods:
- The CHART-2 Study enrolled 10,219 patients, including 4005 Stage B patients categorized by LVEF: preserved (pEF, ≥50%), mid-range (mrEF, 41-49%), and reduced (rEF, ≤40%).
- LVEF transitions among these groups were examined over 1 year.
- Prognostic impacts were assessed by comparing Stage B patients with 4477 Stage C/D HF patients.
Main Results:
- Stage B patients exhibited less severe clinical status and better prognosis than Stage C/D patients.
- In Stage B, mrEF and rEF groups showed dynamic LVEF transitions at 1 year, unlike the stable pEF group.
- LVEF decrease was associated with all-cause mortality in both Stage B and Stage C/D patients with pEF, but with different determining factors.
Conclusions:
- Asymptomatic Stage B heart failure patients demonstrate dynamic LVEF changes with prognostic implications, mirroring findings in Stage C/D patients.
- The underlying factors influencing LVEF changes may differ between asymptomatic Stage B and symptomatic Stage C/D heart failure populations.
Background:
We have recently demonstrated that left ventricular ejection fraction (LVEF) dynamically changes over time with prognostic impacts in Stage C/D patients, namely, those who have a current or past history of heart failure (HF). However, it is unknown whether this is also the case in asymptomatic Stage B patients, namely, those who have a risk of HF, but do not have a history of HF.
Methods:
In our CHART-2 Study (N = 10,219), we enrolled 4005 Stage B patients and divided them into 3 groups by LVEF; preserved EF (pEF, LVEF ≥50%, N = 3526), mid-range EF (mrEF, LVEF 41-49%, N = 302), and reduced EF (rEF, LVEF ≤40%, N = 177). We examined the prognostic impacts of LVEF transitions among the 3 groups in comparison with 4477 patients with Stage C/D HF.
Results:
Stage B were characterized by less severe clinical status and better prognosis compared with Stage C/D. Stage B in mrEF and rEF at baseline dynamically transitioned to other groups at 1-year, whereas those in pEF unchanged; at 1-year, mrEF transitioned to pEF/rEF by 50/16%, and rEF transitioned to pEF/mrEF by 25/31%, respectively, whereas pEF transitioned to mrEF/rEF by only 3.6/0.7%, respectively, which were consistent with findings in findings with Stage C/D. Although LVEF decrease was directly associated with all-cause mortality in both the Stage B and Stage C/D with pEF, factors related to LVEF changes were different between the 2 groups.
Conclusions:
In Stage B, LVEF dynamically changes with prognostic impacts as in Stage C/D, whereas different determination factors may be involved in the 2 stages.
Clinical Trial Registration:
Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 (NCT00418041).
More Related Videos
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:29Heart Failure II: Pathophysiology
01:17Pathophysiology of Heart Failure
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:22Heart Failure Drugs: β-Blockers