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

Research output: Contribution to journalArticle

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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

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Heart Failure
Stroke Volume
Registries
Heart Transplantation
Korea
Hospital Mortality
Cause of Death
Epidemiology
Guidelines
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Cho, Jun Hwan ; Choe, Won Seok ; Cho, Hyun Jai ; Lee, Hae Young ; Jang, Jieun ; Lee, Sang Eun ; Choi, Jin Oh ; Jeon, Eun Seok ; Kim, Min Seok ; Hwang, Kyung Kuk ; Chae, Shung Chull ; Baek, Sang Hong ; Kang, Seok Min ; Choi, Dong Ju ; Yoo, Byung Su ; Kim, Kye Hun ; Cho, Myeong Chan ; Kim, Jae Joong ; Oh, Byung Hee. / Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction. In: Circulation Journal. 2019 ; Vol. 83, No. 2. pp. 347-356.
@article{d0736b2a0d9843738f58db4423ce2ca7,
title = "Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction",
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.",
author = "Cho, {Jun Hwan} and Choe, {Won Seok} and Cho, {Hyun Jai} and Lee, {Hae Young} and Jieun Jang and Lee, {Sang Eun} and Choi, {Jin Oh} and Jeon, {Eun Seok} and Kim, {Min Seok} and Hwang, {Kyung Kuk} and Chae, {Shung Chull} and Baek, {Sang Hong} and Kang, {Seok Min} and Choi, {Dong Ju} and Yoo, {Byung Su} and Kim, {Kye Hun} and Cho, {Myeong Chan} and Kim, {Jae Joong} and Oh, {Byung Hee}",
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Cho, JH, Choe, WS, Cho, HJ, Lee, HY, Jang, J, Lee, SE, Choi, JO, Jeon, ES, Kim, MS, Hwang, KK, Chae, SC, Baek, SH, Kang, SM, Choi, DJ, Yoo, BS, Kim, KH, Cho, MC, Kim, JJ & Oh, BH 2019, 'Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction', Circulation Journal, vol. 83, no. 2, pp. 347-356. https://doi.org/10.1253/circj.CJ-18-0543

Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction. / Cho, Jun Hwan; Choe, Won Seok; Cho, Hyun Jai; Lee, Hae Young; Jang, Jieun; Lee, Sang Eun; Choi, Jin Oh; Jeon, Eun Seok; Kim, Min Seok; Hwang, Kyung Kuk; Chae, Shung Chull; Baek, Sang Hong; Kang, Seok Min; Choi, Dong Ju; Yoo, Byung Su; Kim, Kye Hun; Cho, Myeong Chan; Kim, Jae Joong; Oh, Byung Hee.

In: Circulation Journal, Vol. 83, No. 2, 25.01.2019, p. 347-356.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of characteristics and 3-year outcomes in patients with acute heart failure with preserved, mid-range, and reduced ejection fraction

AU - Cho, Jun Hwan

AU - Choe, Won Seok

AU - Cho, Hyun Jai

AU - Lee, Hae Young

AU - Jang, Jieun

AU - Lee, Sang Eun

AU - Choi, Jin Oh

AU - Jeon, Eun Seok

AU - Kim, Min Seok

AU - Hwang, Kyung Kuk

AU - Chae, Shung Chull

AU - Baek, Sang Hong

AU - Kang, Seok Min

AU - Choi, Dong Ju

AU - Yoo, Byung Su

AU - Kim, Kye Hun

AU - Cho, Myeong Chan

AU - Kim, Jae Joong

AU - Oh, Byung Hee

PY - 2019/1/25

Y1 - 2019/1/25

N2 - 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.

AB - 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.

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U2 - 10.1253/circj.CJ-18-0543

DO - 10.1253/circj.CJ-18-0543

M3 - Article

C2 - 30404976

AN - SCOPUS:85060620908

VL - 83

SP - 347

EP - 356

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 2

ER -