Prognostic impact of left ventricular dilatation in heart failure with mildly reduced ejection fraction.

IF 6.1 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine Pub Date : 2025-09-16 DOI:10.1016/j.ejim.2025.106510

Henning Johann Steffen, Michael Behnes, Jonas Dudda, Alexander Schmitt, Noah Abel, Felix Lau, Marielen Reinhardt, Thomas Bertsch, Kathrin Weidner, Daniel Duerschmied, Ibrahim Akin, Tobias Schupp

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引用次数: 0

Abstract

Objective: This study investigated the prognostic value of left ventricular (LV) dilatation in patients with heart failure with mildly reduced ejection fraction (HFmrEF).

Background: Adverse cardiac remodeling may lead to LV dilatation and impaired prognosis in heart failure with reduced ejection fraction (HFrEF). Its significance in HFmrEF remains unclear.

Methods: Patients hospitalized with HFmrEF (2016-2022) were included and stratified by the presence or absence LV dilatation (males: LV end-diastolic diameter (LVEDD) >58 mm; females: >52 mm). Kaplan-Meier and multivariable Cox regression analyses assessed 30-month all-cause mortality and HF-related rehospitalization.

Results: Among 2154 patients (median LVEDD 49.0 mm), 290 (13.5 %) had LV dilatation. These patients were younger (73 vs. 76 years; p = 0.001), less often males (42.2 % vs. 67.2 %; p = 0.001), and more likely to have non-ischemic cardiomyopathy (10.0 % vs. 6.3 %; p = 0.019). LV dilatation was not associated with 30-month all-cause mortality (29.7 % vs. 31.4 %; HR = 0.933; 95 % CI 0.744-1.171; p = 0.548) but was linked to higher HF-related rehospitalization risk (19.1 % vs. 12.5 %; HR = 1.606; 95 % CI 1.193-2.161; p = 0.003), even after multivariable adjustment (HR = 1.613; 95 % CI 1.163-2.238; p = 0.004).

Conclusion: In HFmrEF, LV dilatation independently predicts HF-related rehospitalization but not all-cause mortality.

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左心室扩张对心力衰竭伴轻度射血分数降低的预后影响。

目的：探讨左室扩张对心力衰竭伴轻度射血分数降低（HFmrEF）患者的预后价值。背景：不良的心脏重构可导致左室扩张和心力衰竭伴射血分数降低（HFrEF）的预后受损。其在HFmrEF中的意义尚不清楚。方法：纳入住院的HFmrEF患者（2016-2022），并根据是否存在左室扩张进行分层(男性：左室舒张末期直径(LVEDD) >58 mm；雌：>52毫米)。Kaplan-Meier和多变量Cox回归分析评估了30个月的全因死亡率和hf相关的再住院。结果：在2154例患者（中位LVEDD 49.0 mm）中，290例（13.5%）发生左室扩张。这些患者较年轻（73岁对76岁，p = 0.001），男性较少（42.2%对67.2%,p = 0.001），更可能患有非缺血性心肌病（10.0%对6.3%,p = 0.019）。左室扩张与30个月全因死亡率无关（29.7% vs. 31.4%; HR = 0.933; 95% CI 0.744-1.171; p = 0.548），但与hf相关的再住院风险较高相关（19.1% vs. 12.5%; HR = 1.606; 95% CI 1.193-2.161; p = 0.003），即使在多变量调整后也是如此（HR = 1.613; 95% CI 1.163-2.238; p = 0.004）。结论：在HFmrEF中，左室扩张独立预测hf相关的再住院，但不能预测全因死亡率。

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

European Journal of Internal Medicine 医学-医学：内科

CiteScore

9.60

自引率

6.20%

发文量

364

审稿时长

20 days

期刊介绍： The European Journal of Internal Medicine serves as the official journal of the European Federation of Internal Medicine and is the primary scientific reference for European academic and non-academic internists. It is dedicated to advancing science and practice in internal medicine across Europe. The journal publishes original articles, editorials, reviews, internal medicine flashcards, and other relevant information in the field. Both translational medicine and clinical studies are emphasized. EJIM aspires to be a leading platform for excellent clinical studies, with a focus on enhancing the quality of healthcare in European hospitals.