Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction

Jun Hwan Cho, Won Seok Choe, Hyun Jai Cho, Hae Young Lee, Jieun Jang, Sang Eun Lee, Jin Oh Choi, Eun Seok Jeon, Min Seok Kim, Kyung Kuk Hwang, Shung Chull Chae, Sang Hong Baek, Seok Min Kang, Dong Ju Choi, Byung Su Yoo, Kye Hun Kim, Myeong Chan Cho, Jae Joong Kim, Byung Hee Oh

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Abstract

Background: The clinical characteristics and outcomes of acute heart failure (AHF) according to left ventricular ejection fraction (LVEF) have not been fully elucidated, especially for patients with mid-range LVEF. We performed a comprehensive comparison of the epidemiology, patterns of in-hospital management, and clinical outcomes in AHF patients with different LVEF categories. Methods and Results: The Korean Acute Heart Failure (KorAHF) registry is a prospective multicenter cohort of hospitalized AHF patients in Korea. A total of 5,374 patients enrolled in the KorAHF registry were classified according to LVEF based on the 2016 ESC guidelines. More than half of the HF patients (58%) had reduced EF (HFrEF), 16% had mid-range EF (HFmrEF), and 25% had preserved EF (HFpEF). The HFmrEF patients showed intermediate epidemiological profiles between HFrEF and HFpEF and had a propensity to present as de-novo HF with ischemic etiology. Patients with lower LVEF had worse short-term outcomes, and the all-cause in-hospital mortality, including urgent heart transplantation, of HFrEF, HFmrEF, and HFpEF was 7.1%, 3.6%, and 3.0%, respectively. Overall, discharged AHF patients showed poor 3-year all-cause death up to 38%, which was comparable between LVEF subgroups (P=0.623). Conclusions: Each LVEF subgroup of AHF patients was a heterogeneous population with diverse characteristics, which have a significant effect on the clinical outcomes. This finding suggested that focused phenotyping of AHF patients could help identify the optimal management strategy and develop novel effective therapies.

Original languageEnglish
Pages (from-to)347-356
Number of pages10
JournalCirculation Journal
Volume83
Issue number2
DOIs
Publication statusPublished - 2019 Jan 25

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Cho, J. H., Choe, W. S., Cho, H. J., Lee, H. Y., Jang, J., Lee, S. E., Choi, J. O., Jeon, E. S., Kim, M. S., Hwang, K. K., Chae, S. C., Baek, S. H., Kang, S. M., Choi, D. J., Yoo, B. S., Kim, K. H., Cho, M. C., Kim, J. J., & Oh, B. H. (2019). Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction. Circulation Journal, 83(2), 347-356. https://doi.org/10.1253/circj.CJ-18-0543