Decompensated Heart Failure with Mid-Range Ejection Fraction: Epidemiology and In-Hospital Mortality Risk Factors
Int. j. cardiovasc. sci. (Impr.)
;
33(1): 45-54, Jan.-Feb. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1090641
ABSTRACT
Abstract Background:
Recently, a new HF entity, with LVEF between 40-49%, was presented to comprehend and seek better therapy for HF with preserved LVEF (HFpEF) and borderline, in the means that HF with reduced LVEF (HFrEF) already has well-defined therapy in the literature.Objective:
To compare the clinical-therapeutic profile of patients with HF with mid-range LVEF (HFmrEF) with HFpEF and HFrEF and to verify predictors of hospital mortality.Method:
Historical cohort of patients admitted with decompensated HF at a supplementary hospital in Recife/PE between April/2007 - August/2017, stratified by LVEF (< 40%/40 - 49/≥ 50%), based on the guideline of the European Society of Cardiology (ESC) 2016. The groups were compared and Logistic Regression was used to identify predictors of independent risk for in-hospital death.Results:
A sample of 493 patients, most with HFrEF (43%), HFpEF (30%) and HFmrEF (26%). Average age of 73 (± 14) years, 59% men. Hospital mortality 14%, readmission within 30 days 19%. In therapeutics, it presented statistical significance among the 3 groups, spironolactone, in HFrEF patients. Hospital death and readmission within 30 days did not make difference. In the HFmrEF group, factors independently associated with death were valve disease (OR 4.17, CI 1.01-9.13), altered urea at admission (OR 6.18, CI 1.78-11.45) and beta-blocker hospitalization (OR 0.29, CI 0.08-0.97). In HFrEF, predictors were prior renal disease (OR 2.84, CI 1.19-6.79), beta-blocker at admission (OR 0.29, CI 0.12-0.72) and ACEI/ ARB (OR 0.21, CI 0.09-0.49). In HFpEF, only valve disease (OR 4.61, CI 1.33-15.96) and kidney disease (OR 5.18, CI 1.68-11.98) were relevant.Conclusion:
In general, HFmrEF presented intermediate characteristics between HFrEF and HFpEF. Independent predictors of mortality may support risk stratification and management of this group.
Full text:
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Index:
LILACS (Americas)
Main subject:
Heart Failure
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Journal subject:
Cardiology
Year:
2020
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Real Hospital Português de Beneficência em Pernambuco/BR
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