Related Experiment Video

Updated: Aug 1, 2025

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
10:03

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

5.4K

Coronary Artery Disease and Prognosis of Heart Failure with Reduced Ejection Fraction

Lourdes Vicent1, Jesús Álvarez-García2, Rafael Vazquez-Garcia3

  • 1Cardiology Department, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain.

Journal of Clinical Medicine
|April 28, 2023
PubMed

Insights

Coronary artery disease (CAD) and idiopathic dilated cardiomyopathy (DCM) have similar prognoses for heart failure with reduced ejection fraction (HFrEF). Patients with DCM were more likely to receive a heart transplant.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Clinical Prognostics

Background:

  • Heart failure with reduced ejection fraction (HFrEF) is a major cause of morbidity and mortality.
  • Understanding the etiological impact on HFrEF prognosis is crucial for patient management.
  • Coronary artery disease (CAD) and idiopathic dilated cardiomyopathy (DCM) are common HFrEF etiologies with potentially different clinical trajectories.

Purpose of the Study:

  • To compare the prognostic impact of CAD versus idiopathic DCM on mortality and readmissions in patients with HFrEF.
  • To evaluate differences in treatment pathways, such as heart transplantation, between these etiological groups.

Main Methods:

  • Analysis of a prospective multicenter registry of 1831 hospitalized heart failure patients.
  • Focus on 583 patients with left ventricular ejection fraction <40%, comparing 266 with CAD etiology and 137 with idiopathic DCM.
  • Statistical comparison of baseline characteristics, one-year mortality, mortality/readmission rates, and heart transplant probability using hazard ratios (HR) and confidence intervals (CI).

Main Results:

  • Patients with CAD had a significantly higher Charlson index (4.4 vs. 2.9, p < 0.001) and more previous hospitalizations (p = 0.015) compared to idiopathic DCM.
  • One-year mortality was similar between groups (CAD HR 1.50, p = 0.182).
  • Overall mortality and readmission rates were comparable (CAD HR 0.96, p = 0.81).
  • Patients with idiopathic DCM had a significantly higher probability of receiving a heart transplant (HR 4.6, p = 0.012).

Conclusions:

  • The prognosis regarding mortality and readmissions for HFrEF is similar between patients with CAD and idiopathic DCM etiologies.
  • Idiopathic DCM patients are more likely to be candidates for or receive heart transplantation.
  • Etiology plays a role in treatment pathways despite similar survival outcomes in HFrEF.

Keywords:
coronary artery diseasedilated cardiomyopathyheart failureischemic heart diseasemortalityreadmissions

More Related Videos

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats06:32

Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats

Published on: June 28, 2019

8.0K
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs07:09

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs

Published on: February 18, 2022

1.9K

Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
22
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
28
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
17
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
128
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K