Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction
BackgroundHeart failure with preserved ejection fraction (HFpEF) patients varied by left ventricular ejection fraction (LVEF) have different clinical characteristics, prognosis, and treatment response. With data from our prospective HFpEF cohort, we assessed the possible relationship between clinica...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.944441/full |
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| author | Jun Gu Jia-han Ke Yue Wang Chang-qian Wang Jun-feng Zhang |
| author_facet | Jun Gu Jia-han Ke Yue Wang Chang-qian Wang Jun-feng Zhang |
| author_sort | Jun Gu |
| collection | DOAJ |
| description | BackgroundHeart failure with preserved ejection fraction (HFpEF) patients varied by left ventricular ejection fraction (LVEF) have different clinical characteristics, prognosis, and treatment response. With data from our prospective HFpEF cohort, we assessed the possible relationship between clinical characteristics, outcome as well as treatment response and LVEF.MethodsWe compared differences in baseline characteristics and clinical outcomes across LVEF categories (50%≤LVEF <60% vs. LVEF≥60%) in 1,502 HFpEF patients, and determined whether LVEF modified the treatment response. During 5-year follow-up, all-cause mortality was used as the primary endpoints, and composite endpoints (all-cause mortality or HF hospitalization) were set as the secondary endpoint.ResultsPatients with higher LVEF were statistically older, more likely to be women and have a history of atrial fibrillation. Patients with lower LVEF category were more likely to have a history of coronary artery disease. The incidences of all-cause mortality and composite endpoints were higher in patients with higher LVEF. Also, LVEF modified the spironolactone treatment effect for the primary outcome and secondary endpoint with stronger estimated benefits at the lower LVEF category with respect to all-cause mortality (HR 0.734, 95% CI 0.541–0.997, P = 0.048) and all-cause mortality or HF hospitalization (HR 0.767, 95% CI 0.604–0.972, P = 0.029).ConclusionThe characteristics and outcomes of HFpEF patients varied substantially by LVEF. Patients with higher LVEF encountered more adverse events than those with lower LVEF. The potential efficacy of spironolactone was greatest at the lower category of LVEF spectrum in HFpEF. |
| first_indexed | 2024-12-10T11:14:30Z |
| format | Article |
| id | doaj.art-7b4f0841592e44938662c47e5128d37f |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-10T11:14:30Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7b4f0841592e44938662c47e5128d37f2022-12-22T01:51:15ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.944441944441Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fractionJun GuJia-han KeYue WangChang-qian WangJun-feng ZhangBackgroundHeart failure with preserved ejection fraction (HFpEF) patients varied by left ventricular ejection fraction (LVEF) have different clinical characteristics, prognosis, and treatment response. With data from our prospective HFpEF cohort, we assessed the possible relationship between clinical characteristics, outcome as well as treatment response and LVEF.MethodsWe compared differences in baseline characteristics and clinical outcomes across LVEF categories (50%≤LVEF <60% vs. LVEF≥60%) in 1,502 HFpEF patients, and determined whether LVEF modified the treatment response. During 5-year follow-up, all-cause mortality was used as the primary endpoints, and composite endpoints (all-cause mortality or HF hospitalization) were set as the secondary endpoint.ResultsPatients with higher LVEF were statistically older, more likely to be women and have a history of atrial fibrillation. Patients with lower LVEF category were more likely to have a history of coronary artery disease. The incidences of all-cause mortality and composite endpoints were higher in patients with higher LVEF. Also, LVEF modified the spironolactone treatment effect for the primary outcome and secondary endpoint with stronger estimated benefits at the lower LVEF category with respect to all-cause mortality (HR 0.734, 95% CI 0.541–0.997, P = 0.048) and all-cause mortality or HF hospitalization (HR 0.767, 95% CI 0.604–0.972, P = 0.029).ConclusionThe characteristics and outcomes of HFpEF patients varied substantially by LVEF. Patients with higher LVEF encountered more adverse events than those with lower LVEF. The potential efficacy of spironolactone was greatest at the lower category of LVEF spectrum in HFpEF.https://www.frontiersin.org/articles/10.3389/fcvm.2022.944441/fullheart failure with preserved ejection fractionleft ventricular ejection fractionprognosistreatment responsephenogroups |
| spellingShingle | Jun Gu Jia-han Ke Yue Wang Chang-qian Wang Jun-feng Zhang Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction Frontiers in Cardiovascular Medicine heart failure with preserved ejection fraction left ventricular ejection fraction prognosis treatment response phenogroups |
| title | Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction |
| title_full | Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction |
| title_fullStr | Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction |
| title_full_unstemmed | Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction |
| title_short | Characteristics, prognosis, and treatment response in HFpEF patients with high vs. normal ejection fraction |
| title_sort | characteristics prognosis and treatment response in hfpef patients with high vs normal ejection fraction |
| topic | heart failure with preserved ejection fraction left ventricular ejection fraction prognosis treatment response phenogroups |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.944441/full |
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