Affiliation:
1. Division of Cardiovascular Medicine Amagasaki‐Chuo Hospital Amagasaki Hyogo Japan
2. Department of Medical Informatics Osaka University Graduate School of Medicine Suita Osaka Japan
3. Division of Cardiology Osaka General Medical Center Osaka Osaka Japan
4. Division of Cardiology Osaka Rosai Hospital Sakai Osaka Japan
5. Division of Cardiology Osaka Police Hospital Osaka Osaka Japan
6. Division of Cardiology Kawanishi City Hospital Kawanishi Hyogo Japan
7. Department of Cardiology Rinku General Medical Center Izumisano Osaka Japan
8. Department of Medical Innovation Osaka University Hospital Suita Osaka Japan
9. Department of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita Osaka Japan
Abstract
Background
Although potential therapeutic candidates for heart failure with preserved ejection fraction (HFpEF) are emerging, it is still unclear whether they will be effective in patients with left ventricular ejection fraction (LVEF) of 60% or higher. Our aim was to identify the clinical characteristics of these patients with HFpEF by comparing them to patients with LVEF below 60%.
Methods and Results
From a multicenter, prospective, observational cohort (PURSUIT‐HFpEF [Prospective Multicenter Obsevational Study of Patients with Heart Failure with Preserved Ejection Fraction]), we investigated 812 consecutive patients (median age, 83 years; 57% women), including 316 with 50% ≤ LVEF <60% and 496 with 60% ≤ LVEF, and compared the clinical backgrounds of the 2 groups and their prognoses for cardiac mortality or HF readmission. Two hundred four adverse outcomes occurred at a median of 366 days. Multivariable Cox regression tests adjusted for age, sex, heart rate, atrial fibrillation, estimated glomerular filtration rate, N‐terminal pro‐B‐type natriuretic peptide, and prior heart failure hospitalization revealed that systolic blood pressure (hazard ratio [HR], 0.925 [95% CI, 0.862–0.992];
P
=0.028), high‐density lipoprotein to C‐reactive protein ratio (HR, 0.975 [95% CI, 0.944–0.995];
P
=0.007), and left ventricular end‐diastolic volume index (HR, 0.870 [95% CI, 0.759–0.997];
P
=0.037) were uniquely associated with outcomes among patients with 50% ≤ LVEF <60%, whereas only the ratio of peak early mitral inflow velocity to velocity of mitral annulus early diastolic motion e′(HR, 1.034 [95% CI, 1.003–1.062];
P
=0.034) was associated with outcomes among patients with 60% ≤ LVEF.
Conclusions
Prognostic factors show distinct differences between patients with HFpEF with 50% ≤ LVEF <60% and with 60% ≤ LVEF. These findings suggest that the 2 groups have different inherent pathophysiology.
Registration
URL:
https://upload.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000024414
; Unique identifier: UMIN000021831 PURSUIT‐HFpEF.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献