Prognostic Implications of Left-Ventricular Function Changes in Young Acute Heart Failure Patients
Hyun-Jin Kim1, Hack-Lyoung Kim2, Myung-A Kim3
1Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Insights
Worsening left ventricular ejection fraction (LVEF) in younger acute heart failure patients predicts poor prognosis. Monitoring and managing LVEF changes are crucial for improving outcomes in this active population.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Acute heart failure (HF) significantly impacts the quality of life for younger, active individuals.
- Understanding the prognosis of acute HF in patients under 50 is essential.
Purpose of the Study:
- To assess clinical features and prognosis of younger acute HF patients based on left ventricular function changes.
- To compare outcomes between patients with improved versus non-improved left ventricular ejection fraction (LVEF) at 1-year follow-up.
Main Methods:
- Multi-center cohort study (March 2011-February 2014) including adults <50 years admitted for acute HF.
- Patients categorized by LVEF change at 1-year follow-up: improved vs. non-improved.
- Primary outcome: all-cause mortality during follow-up.
Main Results:
- 14.6% of patients experienced worsening LVEF at 1 year; 12.8% died.
- The non-improved LVEF group had significantly higher all-cause mortality (32.8% vs. 9.4%).
- Non-improved LVEF was linked to worse clinical outcomes, including death and HF readmission. Angiotensin-converting enzyme inhibitor use predicted reduced risk of non-improved LVEF.
Conclusions:
- Worsening LVEF is associated with poor clinical prognosis in younger acute HF patients.
- Close monitoring and management of LVEF changes are critical for improving clinical outcomes in this demographic.
- Clinicians need to be aware of the specific characteristics and needs of younger acute HF patients.
Background And Objectives:
Heart failure (HF) in younger patients, who are typically active, can significantly affect their quality of life. We assessed the clinical features and prognosis of younger patients with acute HF according to changes in their left ventricular function.
Methods:
This multi-center cohort study was conducted from March 2011 to February 2014 across 10 representative university hospitals. Adult aged <50 years at the time of admission for acute HF were included. Patients were classified into 2 groups according to changes in echocardiographic left ventricular ejection fraction (LVEF) at 1-year follow-up (improved LVEF group vs. non-improved LVEF group). The primary outcome was the incidence of all-cause mortality during the follow-up period.
Results:
Among the 437 patients, 14.6% experienced worsening LVEF at the 1-year follow-up. Fifty-six (12.8%) patients died during the follow-up. The non-improved LVEF group had a higher incidence of all-cause mortality than the improved LVEF groups (32.8% vs. 9.4%, p<0.001). Clinical outcomes, including all-cause death, cardiac death, and HF readmission were significantly worse in the non-improved LVEF group. Multivariate logistic regression analysis identified angiotensin converting enzyme inhibitor use at discharge as an independent predictor of reduced risk of non-improved LVEF (odds ratio, 0.37; 95% confidence interval, 0.171-0.786).
Conclusions:
Worsening LVEF was associated with poor clinical prognosis in younger patients hospitalized for acute HF. Clinicians should be aware of the characteristics of younger patients with acute HF and monitoring and treating changes in LVEF in younger patients with acute HF is crucial for improving clinical outcomes.
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