Clinical Characteristics, Comorbidities and Prognosis in Patients With Heart Failure With Mid-Range Ejection Fraction

Area of Science:

• Cardiology
• Internal Medicine
• Public Health

Background:

• Heart failure with mid-range ejection fraction (HFmrEF) is defined by left ventricular ejection fraction between 40%-49%.
• Understanding HFmrEF patient characteristics, especially in rural settings, is crucial due to potential prognostic and therapeutic differences.
• This study focuses on the clinical profile and outcomes of HFmrEF in a rural community.

Purpose of the Study:

• To evaluate the clinical characteristics of rural patients diagnosed with HFmrEF.
• To identify comorbidities prevalent in this rural HFmrEF population.
• To assess the prognosis and outcomes of HFmrEF in a rural community-based setting.

Main Methods:

• Retrospective analysis of electronic medical records from a community-based university practice.
• Inclusion criteria: HF diagnosis, >3 months follow-up, interpretable Doppler echocardiograms.
• Data collected: demographics, echocardiogram variables, and outcomes up to 2,083 days.

Main Results:

• HFmrEF constituted 36.4% of the 633 HF patients studied.
• HFmrEF patients were older, with higher coronary disease prevalence, lower blood pressure, elevated brain natriuretic peptide, lower hemoglobin, and higher creatinine compared to HFpEF.
• All-cause mortality was intermediate between HFrEF and HFpEF; a trend towards higher readmission in HFmrEF vs. HFpEF was observed (HR 1.43, P=0.0767).

Conclusions:

• Rural HFmrEF patients, particularly those without specialized clinics, represent a significant proportion of heart failure cases.
• This population exhibits greater coronary disease prevalence.
• Outcomes show comparable readmission rates and nonsignificantly different all-cause mortality compared to other HF phenotypes.