Diagnosis, clinical course, and 1-year outcome in patients hospitalized for heart failure with preserved ejection fraction (from the Polish Cohort of the European Society of Cardiology Heart Failure Long-Term Registry)

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Diagnosis, clinical course, and 1-year outcome in patients hospitalized for heart failure with preserved ejection fraction (from the Polish Cohort of the European Society of Cardiology Heart Failure Long-Term Registry)Author(s)
Date
2016Citation
Kaplon-Cieslicka A, Tyminska A, Peller M, et al. Diagnosis, clinical course, and 1-year outcome in patients hospitalized for heart failure with preserved ejection fraction (from the Polish Cohort of the European Society of Cardiology Heart Failure Long-Term Registry). Am J Cardiol. 2016; 118(4): 535-542
Abstract
[Abstract] Compared with heart failure (HF) with reduced ejection fraction (HF-REF), the diagnosis of HF with preserved EF (HF-PEF) is more challenging. The aim of the study was to assess the prevalence of HF-PEF among patients hospitalized for HF, to evaluate the pertinence of HF-PEF diagnosis and to compare HF-PEF and HF-REF patients with respect to outcomes. The analysis included 661 Polish patients hospitalized for HF, selected from the European Society of Cardiology (ESC)-HF Long-Term Registry. Patients with an EF of ≥50% were included in the HF-PEF group and patients with an EF of <50% - in the HF-REF group. The primary end point was all-cause death at 1 year. The secondary end point was a composite of all-cause death and rehospitalization for HF at 1 year. HF-PEF was present in 187 patients (28%). Of those 187 patients, mitral inflow pattern was echocardiographically assessed in 116 patients (62%) and classified as restrictive/pseudonormal in 37 patients (20%). Compared with HF-REF subjects, patients with HF-PEF were older, more often female, and had a higher prevalence of hypertension, atrial fibrillation and sleep apnea. Despite lower B-type natriuretic peptide concentrations and lower prevalence of moderate-to-severe mitral regurgitation in patients with HF-PEF, congestive symptoms at admission were as severe as in patients with HF-REF. There were no significant differences in in-hospital mortality between the HF groups. One-year mortality was high in both groups (17% in HF-PEF vs 21% in HF-REF, p = 0.22). There was a trend toward a lower frequency of the secondary end point in the HF-PEF group (32% vs 40%, p = 0.07). In conclusion, in clinical practice, even easily obtainable echocardiographic indexes of diastolic dysfunction are relatively rarely acquired. One-year survival rate of patients with HF-PEF is not significantly better than that of patients with HF-REF.
Keywords
Atrial fibrillation
Comorbidity
Disease progression
Echocardiography
Heart failure
Hospital mortality
Hospitalization
Hypertension
Natriuretic peptides
Brain
Severity of illness index
Sleep apnea syndromes
Stroke volume
Poland
Comorbidity
Disease progression
Echocardiography
Heart failure
Hospital mortality
Hospitalization
Hypertension
Natriuretic peptides
Brain
Severity of illness index
Sleep apnea syndromes
Stroke volume
Poland
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Atribución-NoComercial-SinDerivadas 3.0 España
ISSN
0002-9149