Beyond the Initial Insult: Clinical Characteristics and Prognosis of Heart Failure with Improved Ejection Fraction.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2024-07-26 DOI:10.1159/000540597

Israel Gotsman, Donna R Zwas, Andre Keren, Offer Amir, David Leibowitz

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引用次数: 0

Abstract

Introduction: Heart failure with improved ejection fraction (HFimpEF) is a recently defined subtype of HF, characterized by an increase in ejection fraction (EF) after a prior diagnosis of reduced EF. There are limited data on the characteristics and outcome of this patient subset. The study aimed to investigate the clinical profile and prognosis of this patient group.

Methods: HFimpEF patients from a large echocardiography database with comprehensive clinical and outcome data were evaluated for clinical characteristics and outcomes including mortality and cardiovascular hospitalizations. HFimpEF was defined as prior HF diagnosis with EF ≤40% followed by an EF increase of ≥10% to >40%.

Results: The study included 2,883 patients with an EF ≤40%. 27% (777) fulfilled criteria of HFimpEF. Non-ischemic cardiomyopathy, female sex, and smaller left ventricular dimensions were associated with EF improvement. Median follow-up duration was 1,346 days. Patients with HFimpEF had a significantly improved prognosis compared to those without EF improvement. Patients with a significant improvement in the EF (≥50%) experienced a 30% lower mortality rate (HR: 0.70, 95% CI: 0.57-0.86, p < 0.001) and a decreased risk of cardiovascular hospitalizations.

Conclusions: HFimpEF is a distinct clinical entity observed in 27% of patients with initially reduced EF and conveys a better prognosis. However, even with improvement, EF in most patients does not fully recover, and clinical events can still occur.

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超越最初的伤害：射血分数改善型心力衰竭的临床特征和预后。

简介射血分数改善型心力衰竭（HFimpEF）是最近定义的一种心力衰竭亚型，其特点是射血分数（EF）在之前被诊断为降低后有所增加。关于这一患者亚群的特征和预后的数据十分有限。该研究旨在调查这一患者群体的临床特征和预后。方法：对来自大型超声心动图数据库的 HFimpEF 患者的临床特征和预后（包括死亡率和心血管住院率）进行评估，该数据库具有全面的临床和预后数据。HFimpEF的定义是既往诊断为HF且EF≤40%，随后EF增加≥10%至40%：研究纳入了2883名EF≤40%的患者。27%的患者（777人）符合HFimpEF标准。非缺血性心肌病、女性和较小的左心室尺寸与EF改善有关。中位随访时间为 1346 天。与EF值未改善的患者相比，HFimpEF患者的预后明显改善。EF明显改善（≥50%）的患者死亡率降低30%（HR 0.70，95% CI 0.57-0.86，P<0.001），心血管住院风险降低：HFimpEF是一个独特的临床实体，27%的患者最初EF值降低，预后较好。然而，即使有所改善，大多数患者的 EF 也不会完全恢复，临床事件仍有可能发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.