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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

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The influence of non-cardiac comorbidities burden on heart failure with improved ejection fraction: Evaluated by

Xuefu Chen1, Xinxin Zhang1, Mei Yang1

  • 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, 116021, China.

International Journal of Cardiology
|November 28, 2025
PubMed

Insights

Non-cardiac comorbidity burden significantly impacts heart failure with improved ejection fraction (HFimpEF) outcomes. High comorbidity burden worsens HFimpEF prognosis and predicts fewer HFimpEF cases.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Heart failure (HF) classification includes HF with improved ejection fraction (HFimpEF).
  • Previous research focused on cardiac factors, overlooking non-cardiac comorbidities (NCCs) in HFimpEF.
  • This study examines the impact of overall NCCs burden on HFimpEF outcomes.

Purpose of the Study:

  • To investigate the role of overall non-cardiac comorbidity burden in HFimpEF.
  • To determine if NCCs burden affects clinical outcomes in HFimpEF patients.
  • To assess NCCs burden as a predictor for developing HFimpEF.

Main Methods:

  • Retrospective cohort study of HF with reduced ejection fraction (HFrEF) patients.
  • Patients categorized into HFimpEF and persistent HFrEF groups.
  • Non-cardiac comorbidity burden quantified using the modified Charlson Comorbidity Index (CCI).
  • Adverse endpoints included all-cause or cardiovascular mortality and rehospitalization.

Main Results:

  • 1106 patients included: 346 HFimpEF, 760 persistent HFrEF.
  • HFimpEF patients generally had better outcomes than persistent HFrEF.
  • Modified CCI score independently predicted worse prognosis; high NCCs burden increased adverse endpoints, particularly mortality in HFimpEF.
  • Higher NCCs burden was associated with fewer HFimpEF occurrences.
  • Modified CCI score ≥ 2 was a negative predictor for HFimpEF.

Conclusions:

  • Non-cardiac comorbidity burden is critical for evaluating HFimpEF, beyond cardiac parameters.
  • Significant NCCs burden in HFimpEF patients correlates with worse clinical outcomes.
  • High NCCs burden negatively predicts HFimpEF development, suggesting its utility in risk stratification.
Abstract

Keywords:
Charlson comorbidity indexHeart failure with improved ejection fractionNon-cardiac comorbidityPredictionPrognosis

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