Characteristics and Prognosis of Herat Failure with Improved Ejection Fraction
BackgroundLeft ventricular ejection fraction (LVEF) is often used to classify heart failure (HF) . Some HF patients were observed to have improved ejection fraction after treatment, thus giving rise to the concept of HF with improved EF (HFimpEF) . However, most relevant studies have focused on Euro...
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| Format: | Article |
| Language: | zho |
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Chinese General Practice Publishing House Co., Ltd
2022-02-01
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| Series: | Zhongguo quanke yixue |
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| Online Access: | https://www.chinagp.net/fileup/1007-9572/PDF/1643428302762-1997343359.pdf |
| _version_ | 1797217276416491520 |
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| author | SU Kangkang, WANG Yan, WANG Lili, CHEN Shuxia, GU Jian |
| author_facet | SU Kangkang, WANG Yan, WANG Lili, CHEN Shuxia, GU Jian |
| author_sort | SU Kangkang, WANG Yan, WANG Lili, CHEN Shuxia, GU Jian |
| collection | DOAJ |
| description | BackgroundLeft ventricular ejection fraction (LVEF) is often used to classify heart failure (HF) . Some HF patients were observed to have improved ejection fraction after treatment, thus giving rise to the concept of HF with improved EF (HFimpEF) . However, most relevant studies have focused on European countries and the US, and there are few reports on the clinical characteristics and diagnosis of this population in China.ObjectiveTo analyze the clinical characteristics, prognosis and prognostic predictors in Chinese HFimpEF patients.MethodsParticipants included in this case-control study were chronic HF inpatients who were recruited from Department of Heart Center, Hebei General Hospital from June 1, 2018, to May 1, 2020. Demographic data and baseline clinical information were obtained from the electronic medical record, in particular, clinical phenotypes of HF classified by baseline and follow-up LVEF included four: HF with preserved EF (HFpEF) , HF with mid-range EF (HFmrEF) , HF with reduced EF (HFrEF) and HFimpEF. Follow-up was conducted via electronic medical record review, outpatient department and telephone since the last reexamination with echocardiography. The follow-up continued through 2021-06-01, with all-cause death and all-cause readmission as endpoint events. Predictors of HFimpEF were explored by binary Logistic regression. Kaplan-Meier estimator was used to describe the survival of patients with all-cause death and all-cause readmission. Cox regression model was used to identify risk factors for all-cause death and all-cause readmission.ResultsA total of 530 cases were included, including 245 (46.2%) with HFpEF, 55 (10.4%) with HFmrEF, 133 (25.1%) with HFrEF, and 97 (18.3%) with HFimpEF. HFimpEF patients had lower mortality than did HFpEF patients (P=0.014) and HFmrEF patients (P<0.001) . The readmission rate was lower in HFimpEF patients than that of HFpEF (P=0.011) or HFmrEF patients (P=0.001) . Elevated systolic blood pressure〔OR=1.036, 95%CI (1.019, 1.053) , P<0.001〕, and left ventricular end-systolic diameter (LVESD) ≤37 mm〔OR=0.245, 95%CI (0.118, 0.507) , P<0.001〕 at baseline, and treatments with beta-blockers〔OR=2.868, 95%CI (1.304, 6.305) , P=0.009〕 and aldosterone antagonists〔OR=2.691, 95%CI (1.316, 5.503) , P=0.007〕 were associated with increased probability of LVEF improvement. HFrEF, older age, heart valve disease, chronic kidney disease, anemia, non-use of beta-blockers and oral anticoagulants were independently associated with increased risk of all-cause death in HF patients (P<0.05) . HFpEF, HFmrEF and chronic kidney disease were independently associated with increased risk of all-cause readmission in HF patients (P<0.05) . Concomitant valvular heart disease〔HR=6.499, 95%CI (1.504, 28.089) , P=0.012〕and anemia〔HR=4.884, 95%CI (1.242, 19.208) , P=0.023〕were independently associated with increased risk of all-cause death in HFimpEF patients. The use of beta-blockers〔HR=2.868, 95%CI (1.304, 6.305) P=0.009〕 and aldosterone antagonists〔HR=2.691, 95%CI (1.316, 5.503) , P=0.007〕 were associated with increased probability of LVEF improvement.ConclusionWe consider that HFimpEF is a clinical phenotype of HF manifested as milder clinical symptoms, less ventricular remodelling and a better prognosis. Elevated systolic blood pressure, LVESD≤37 mm and treatments with beta-blockers and aldosterone receptor antagonists may be independent predictors of improved LVEF, while valvular heart disease and anaemia may be risk factors for all-cause death in HFimpEF patients. |
| first_indexed | 2024-04-24T11:59:17Z |
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| id | doaj.art-fc8e994cc79b4624b05e62fe7e0c460c |
| institution | Directory Open Access Journal |
| issn | 1007-9572 |
| language | zho |
| last_indexed | 2024-04-24T11:59:17Z |
| publishDate | 2022-02-01 |
| publisher | Chinese General Practice Publishing House Co., Ltd |
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| series | Zhongguo quanke yixue |
| spelling | doaj.art-fc8e994cc79b4624b05e62fe7e0c460c2024-04-09T02:50:52ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722022-02-01250556857610.12114/j.issn.1007-9572.2021.01.050Characteristics and Prognosis of Herat Failure with Improved Ejection FractionSU Kangkang, WANG Yan, WANG Lili, CHEN Shuxia, GU Jian0 1.Graduate School of Hebei North University，Zhangjiakou 075000，China 2.Graduate School of Hebei Medical University，Shijiazhuang 050017，China 3.Department of Heart Center，Hebei General Hospital，Shijiazhuang 050051，China *Corresponding author：CHEN Shuxia，Professor，Chief physician；E-mail：shuxia.chen@126.com BackgroundLeft ventricular ejection fraction (LVEF) is often used to classify heart failure (HF) . Some HF patients were observed to have improved ejection fraction after treatment, thus giving rise to the concept of HF with improved EF (HFimpEF) . However, most relevant studies have focused on European countries and the US, and there are few reports on the clinical characteristics and diagnosis of this population in China.ObjectiveTo analyze the clinical characteristics, prognosis and prognostic predictors in Chinese HFimpEF patients.MethodsParticipants included in this case-control study were chronic HF inpatients who were recruited from Department of Heart Center, Hebei General Hospital from June 1, 2018, to May 1, 2020. Demographic data and baseline clinical information were obtained from the electronic medical record, in particular, clinical phenotypes of HF classified by baseline and follow-up LVEF included four: HF with preserved EF (HFpEF) , HF with mid-range EF (HFmrEF) , HF with reduced EF (HFrEF) and HFimpEF. Follow-up was conducted via electronic medical record review, outpatient department and telephone since the last reexamination with echocardiography. The follow-up continued through 2021-06-01, with all-cause death and all-cause readmission as endpoint events. Predictors of HFimpEF were explored by binary Logistic regression. Kaplan-Meier estimator was used to describe the survival of patients with all-cause death and all-cause readmission. Cox regression model was used to identify risk factors for all-cause death and all-cause readmission.ResultsA total of 530 cases were included, including 245 (46.2%) with HFpEF, 55 (10.4%) with HFmrEF, 133 (25.1%) with HFrEF, and 97 (18.3%) with HFimpEF. HFimpEF patients had lower mortality than did HFpEF patients (P=0.014) and HFmrEF patients (P<0.001) . The readmission rate was lower in HFimpEF patients than that of HFpEF (P=0.011) or HFmrEF patients (P=0.001) . Elevated systolic blood pressure〔OR=1.036, 95%CI (1.019, 1.053) , P<0.001〕, and left ventricular end-systolic diameter (LVESD) ≤37 mm〔OR=0.245, 95%CI (0.118, 0.507) , P<0.001〕 at baseline, and treatments with beta-blockers〔OR=2.868, 95%CI (1.304, 6.305) , P=0.009〕 and aldosterone antagonists〔OR=2.691, 95%CI (1.316, 5.503) , P=0.007〕 were associated with increased probability of LVEF improvement. HFrEF, older age, heart valve disease, chronic kidney disease, anemia, non-use of beta-blockers and oral anticoagulants were independently associated with increased risk of all-cause death in HF patients (P<0.05) . HFpEF, HFmrEF and chronic kidney disease were independently associated with increased risk of all-cause readmission in HF patients (P<0.05) . Concomitant valvular heart disease〔HR=6.499, 95%CI (1.504, 28.089) , P=0.012〕and anemia〔HR=4.884, 95%CI (1.242, 19.208) , P=0.023〕were independently associated with increased risk of all-cause death in HFimpEF patients. The use of beta-blockers〔HR=2.868, 95%CI (1.304, 6.305) P=0.009〕 and aldosterone antagonists〔HR=2.691, 95%CI (1.316, 5.503) , P=0.007〕 were associated with increased probability of LVEF improvement.ConclusionWe consider that HFimpEF is a clinical phenotype of HF manifested as milder clinical symptoms, less ventricular remodelling and a better prognosis. Elevated systolic blood pressure, LVESD≤37 mm and treatments with beta-blockers and aldosterone receptor antagonists may be independent predictors of improved LVEF, while valvular heart disease and anaemia may be risk factors for all-cause death in HFimpEF patients.https://www.chinagp.net/fileup/1007-9572/PDF/1643428302762-1997343359.pdf|heart failure|cardiovascular diseases|left ventricular ejection fraction|ventricular remodeling|improved ejection fraction|disease attributes|prognosis|root cause analysis|survival analysis |
| spellingShingle | SU Kangkang, WANG Yan, WANG Lili, CHEN Shuxia, GU Jian Characteristics and Prognosis of Herat Failure with Improved Ejection Fraction Zhongguo quanke yixue |heart failure|cardiovascular diseases|left ventricular ejection fraction|ventricular remodeling|improved ejection fraction|disease attributes|prognosis|root cause analysis|survival analysis |
| title | Characteristics and Prognosis of Herat
Failure with Improved Ejection Fraction |
| title_full | Characteristics and Prognosis of Herat
Failure with Improved Ejection Fraction |
| title_fullStr | Characteristics and Prognosis of Herat
Failure with Improved Ejection Fraction |
| title_full_unstemmed | Characteristics and Prognosis of Herat
Failure with Improved Ejection Fraction |
| title_short | Characteristics and Prognosis of Herat
Failure with Improved Ejection Fraction |
| title_sort | characteristics and prognosis of herat failure with improved ejection fraction |
| topic | |heart failure|cardiovascular diseases|left ventricular ejection fraction|ventricular remodeling|improved ejection fraction|disease attributes|prognosis|root cause analysis|survival analysis |
| url | https://www.chinagp.net/fileup/1007-9572/PDF/1643428302762-1997343359.pdf |
| work_keys_str_mv | AT sukangkangwangyanwanglilichenshuxiagujian characteristicsandprognosisofheratfailurewithimprovedejectionfraction |