Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry

O. Chioncel, M. Lainscak, P.M. Seferovic, S.D. Anker, M.G. Crespo-Leiro, V.-P. Harjola, J. Parissis, C. Laroche, M.F. Piepoli, C. Fonseca, A. Mebazaa, L. Lund, G.A. Ambrosio, A.J. Coats, R. Ferrari, F. Ruschitzka, A.P. Maggioni, G. Filippatos

Research output: Contribution to journalArticle

197 Citations (Scopus)

Abstract

Aims: The objectives of the present study were to describe epidemiology and outcomes in ambulatory heart failure (HF) patients stratified by left ventricular ejection fraction (LVEF) and to identify predictors for mortality at 1 year in each group. Methods and results: The European Society of Cardiology Heart Failure Long-Term Registry is a prospective, observational study collecting epidemiological information and 1-year follow-up data in 9134 HF patients. Patients were classified according to baseline LVEF into HF with reduced EF [EF 50% (HFpEF)]. In comparison with HFpEF subjects, patients with HFrEF were younger (64 years vs. 69 years), more commonly male (78% vs. 52%), more likely to have an ischaemic aetiology (49% vs. 24%) and left bundle branch block (24% vs. 9%), but less likely to have hypertension (56% vs. 67%) or atrial fibrillation (18% vs. 32%). The HFmrEF group resembled the HFrEF group in some features, including age, gender and ischaemic aetiology, but had less left ventricular and atrial dilation. Mortality at 1 year differed significantly between HFrEF and HFpEF (8.8% vs. 6.3%); HFmrEF patients experienced intermediate rates (7.6%). Age, New York Heart Association (NYHA) class III/IV status and chronic kidney disease predicted mortality in all LVEF groups. Low systolic blood pressure and high heart rate were predictors for mortality in HFrEF and HFmrEF. A lower body mass index was independently associated with mortality in HFrEF and HFpEF patients. Atrial fibrillation predicted mortality in HFpEF patients. Conclusions: Heart failure patients stratified according to different categories of LVEF represent diverse phenotypes of demography, clinical presentation, aetiology and outcomes at 1 year. Differences in predictors for mortality might improve risk stratification and management goals. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology
Original languageEnglish
Pages (from-to)1574-1585
Number of pages12
JournalEUROPEAN JOURNAL OF HEART FAILURE
Volume19
Issue number12
DOIs
Publication statusPublished - Dec 2017

Keywords

  • Ambulatory
  • Chronic
  • Heart failure
  • Left ventricular ejection fraction
  • Outcomes
  • adult
  • age
  • aged
  • all cause mortality
  • Article
  • atrial fibrillation
  • body mass
  • chronic kidney failure
  • controlled study
  • disease registry
  • female
  • heart atrium enlargement
  • heart failure
  • heart failure with preserved ejection fraction
  • heart failure with reduced ejection fraction
  • heart left bundle branch block
  • heart left ventricle ejection fraction
  • heart left ventricle hypertrophy
  • heart rate
  • hospitalization
  • human
  • hypertension
  • ischemic heart disease
  • major clinical study
  • male
  • New York Heart Association class
  • priority journal
  • systolic blood pressure

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