Clinical characteristics, one-year change in ejection fraction and long-term outcomes in patients with heart failure with mid-range ejection fraction: a multicentre prospective observational study in Catalonia (Spain)

Farré López, Núria; Lupón, Josep; Roig, Eulàlia; Gonzalez-Costello, Jose; Vila, Joan; Pérez, Silvia; De Antonio Cuscó, Marta; Solé-González, Eduard; Sánchez-Enrique, Cristina; Moliner Borja, Pedro; Ruiz-Bustillo, Sonia; Enjuanes Grau, Cristina; Mirabet, Sonia; Bayes-Genis, Antoni; Comín Colet, Josep; GICCAT investigators

Clinical characteristics, one-year change in ejection fraction and long-term outcomes in patients with heart failure with mid-range ejection fraction: a multicentre prospective observational study in Catalonia (Spain)

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dc.contributor.author Farré López, Núriaca
dc.contributor.author Lupón, Josepca
dc.contributor.author Roig, Eulàliaca
dc.contributor.author Gonzalez-Costello, Joseca
dc.contributor.author Vila, Joanca
dc.contributor.author Pérez, Silviaca
dc.contributor.author De Antonio Cuscó, Martaca
dc.contributor.author Solé-González, Eduardca
dc.contributor.author Sánchez-Enrique, Cristinaca
dc.contributor.author Moliner Borja, Pedroca
dc.contributor.author Ruiz-Bustillo, Soniaca
dc.contributor.author Enjuanes Grau, Cristinaca
dc.contributor.author Mirabet, Soniaca
dc.contributor.author Bayes-Genis, Antonica
dc.contributor.author Comín Colet, Josepca
dc.contributor.author GICCAT investigatorsca
dc.date.accessioned 2018-10-19T07:17:16Z
dc.date.available 2018-10-19T07:17:16Z
dc.date.issued 2017
dc.description.abstract OBJECTIVES: The aim of this study was to analyse baseline characteristics and outcome of patients with heart failure and mid-range left ventricular ejection fraction (HFmrEF, left ventricular ejection fraction (LVEF) 40%-49%) and the effect of 1-year change in LVEF in this group. SETTING: Multicentre prospective observational study of ambulatory patients with HF followed up at four university hospitals with dedicated HF units. PARTICIPANTS: Fourteen per cent (n=504) of the 3580 patients included had HFmrEF. INTERVENTIONS: Baseline characteristics, 1-year LVEF and outcomes were collected. All-cause death, HF hospitalisation and the composite end-point were the primary outcomes. RESULTS: Median follow-up was 3.66 (1.69-6.04) years. All-cause death, HF hospitalisation and the composite end-point were 47%, 35% and 59%, respectively. Outcomes were worse in HF with preserved ejection fraction (HFpEF) (LVEF>50%), without differences between HF with reduced ejection fraction (HFrEF) (LVEF<40%) and HFmrEF (all-cause mortality 52.6% vs 45.8% and 43.8%, respectively, P=0.001). After multivariable Cox regression analyses, no differences in all-cause death and the composite end-point were seen between the three groups. HF hospitalisation and cardiovascular death were not statistically different between patients with HFmrEF and HFrEF. At 1-year follow-up, 62% of patients with HFmrEF had LVEF measured: 24% had LVEF<40%, 43% maintained LVEF 40%-49% and 33% had LVEF>50%. While change in LVEF as continuous variable was not associated with better outcomes, those patients who evolved from HFmrEF to HFpEF did have a better outcome. Those who remained in the HFmrEF and HFrEF groups had higher all-cause mortality after adjustment for age, sex and baseline LVEF (HR 1.96 (95% CI 1.08 to 3.54, P=0.027) and HR 2.01 (95% CI 1.04 to 3.86, P=0.037), respectively). CONCLUSIONS: Patients with HFmrEF have a clinical profile in-between HFpEF and HFrEF, without differences in all-cause mortality and the composite end-point between the three groups. At 1 year, patients with HFmrEF exhibited the greatest variability in LVEF and this change was associated with survival.
dc.format.mimetype application/pdf
dc.identifier.citation Farré N, Lupon J, Roig E, Gonzalez-Costello J, Vila J0, Perez S. el al. Clinical characteristics, one-year change in ejection fraction and long-term outcomes in patients with heart failure with mid-range ejection fraction: a multicentre prospective observational study in Catalonia (Spain). BMJ Open. 2017 Dec 21;7(12):e018719. DOI : 10.1136/bmjopen-2017-018719
dc.identifier.doi http://dx.doi.org/10.1186/s13104-017-3024-8
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10230/35622
dc.language.iso eng
dc.publisher BMJ Publishing Groupca
dc.relation.ispartof BMJ Open. 2017 Dec 21;7(12):e018719
dc.rights Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.keyword Echocardiography
dc.subject.keyword Ejection fraction
dc.subject.keyword Heart failure
dc.subject.keyword Prognosis
dc.subject.keyword Recovered
dc.subject.other Infart de miocardi -- Prognosi
dc.subject.other Ecocardiografia
dc.subject.other Cor -- Malalties
dc.title Clinical characteristics, one-year change in ejection fraction and long-term outcomes in patients with heart failure with mid-range ejection fraction: a multicentre prospective observational study in Catalonia (Spain)ca
dc.type info:eu-repo/semantics/article
dc.type.version info:eu-repo/semantics/publishedVersion

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