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Updated: Nov 6, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Cutoff 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

348

First-Phase Ejection Fraction, a Measure of Preclinical Heart Failure, Is Strongly Associated With Increased

Haotian Gu1, Chiara Cirillo2, Adam A Nabeebaccus1,3

  • 1British Heart Foundation Centre, King's College London, United Kingdom (H.G., A.A.N., O.D., K.O., M.M., D.P., M.R., L. Faconti, A. Papachristidis, G.C.-W., A.M.S., P.C.).

Hypertension (Dallas, Tex. : 1979)
|May 10, 2021
PubMed

Insights

First-phase ejection fraction (EF1), a measure of preclinical heart failure, strongly predicts survival in COVID-19 patients. Impaired EF1 indicates higher mortality risk, suggesting underlying heart conditions worsen COVID-19 outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Heart failure presence is linked to poor prognosis in COVID-19 patients.
  • Early systolic ejection fraction (EF1) is a sensitive indicator of preclinical heart failure.

Purpose of the Study:

  • To investigate the association between EF1 and survival in hospitalized COVID-19 patients.
  • To determine if EF1 is a stronger predictor of survival than other clinical and laboratory markers.

Main Methods:

  • Retrospective outcome study involving 380 COVID-19 patients who underwent echocardiography in Wuhan and London.
  • Cox proportional hazards regression used to analyze EF1's association with survival.
  • Comparison of EF1 in COVID-19 patients versus 266 historical controls with similar comorbidities.

Main Results:

  • EF1 was a significant predictor of survival in both Wuhan and London COVID-19 patient groups.
  • In the combined cohort, EF1 outperformed age, comorbidities, and biochemical markers in predicting survival.
  • A cutoff EF1 of 25% showed a hazard ratio of 4.83 (adjusted) for mortality.

Conclusions:

  • Impaired EF1 is strongly associated with increased mortality in COVID-19 patients.
  • EF1 likely reflects pre-existing, preclinical heart failure contributing to COVID-19 severity.
  • EF1 serves as a valuable prognostic marker in COVID-19 management.

Keywords:
COVID-19ejection fractionheart failureprevalenceprognosisrisk factorsystole

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