Prevalence and Prognostic Implications of Longitudinal Ejection Fraction Change in Heart Failure

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Prevalence and Prognostic Implications of Longitudinal Ejection Fraction Change in Heart Failure

Savarese, Gianluigi (författare): Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden

Vedin, Ola (författare): Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR),Boehringer Ingelheim AB, Stockholm, Sweden,Uppsala Univ, Sweden; Uppsala Clin Res Ctr, Sweden; Boehringer Ingelheim AB, Sweden

D'Amario, Domenico (författare): Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli, Inst Cardiol, Inst Sci Res & Treatment, Rome, Italy

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Uijl, Alicia (författare): Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden; Univ Utrecht, Netherlands

Dahlström, Ulf (författare): Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US

Rosano, Giuseppe (författare): IRCCS San Raffaele Hosp, Dept Med Sci, Rome, Italy

Lam, Carolyn S. P. (författare): Duke NUS Med Sch, Natl Heart Ctr Singapore, Singapore, Singapore;Univ Med Ctr Groningen, Groningen, Netherlands

Lund, Lars H. (författare): Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden

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(creator_code:org_t)

ELSEVIER SCI LTD, 2019
2019
Engelska.
Ingår i: JACC. Heart failure. - : ELSEVIER SCI LTD. - 2213-1779 .- 2213-1787. ; 7:4, s. 306-317

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; https://urn.kb.se/re...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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OBJECTIVES: This study sought to evaluate the incidence, the predictors, and the associations with outcomes of changes in ejection fraction (EF) in heart failure (HF) patients.BACKGROUND: EF determines therapy in HF, but information is scarce about incidence, determinants, and prognostic implications of EF change over time.METHODS: Patients with >= 2 EF measurements were made in the Swedish Heart Failure Registry were categorized as heart failure with preserved ejection fraction (HFpEF) (EF >= 50%), heart failure with midrange ejection fraction (HFmrEF) (EF 40% to 49%), or heart failure with reduced ejection fraction (HFrEF) (EF <40%). Changes among categories were recorded, and associations among EF changes, predictors, and all-cause mortality and/or HF hospitalizations were analyzed using logistic and Cox regressions.RESULTS: Of 4,942 patients at baseline, 18% had HFpEF, 19% had HFmrEF, and 63% had HFrEF. During follow-up, 21% and 18% of HFpEF patients transitioned to HFmrEF and HFrEF, respectively; 37% and 25% of HFmrEF patients transitioned to HFrEF and HFpEF, respectively; and 16% and 10% of HFrEF patients transitioned to HFmrEF and HFpEF, respectively. Predictors of increased EF included use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, female sex, cases of less severe HF, and comorbidities. Predictors of decreased EF included diabetes, ischemic heart disease, and cases of more severe HF. Increased EF was associated with a lower risk (hazard ratio [HR]: 0.62; 95% confidence interval [CI]: 0.55 to 0.69) and decreased EF with a higher risk (HR: 1.15; 95% CI: 1.01 to 1.30) of mortality and/or HF hospitalizations. Prognostic implications were most evident for transitions to and from HFrEF.CONCLUSIONS: Increases in EF occurred in one-fourth of HFrEF and HFmrEF patients, and decreases occurred in more than one-third of patients with HFpEF and HFmrEF. EF change was associated with a wide range of important clinical, treatment, and organizational factors as well as with outcomes, particularly transitions to and from HFrEF.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

ejection fraction
heart failure
predictors
prognosis

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JACC. Heart failure (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Savarese, Gianlu ...; Vedin, Ola; D'Amario, Domeni ...; Uijl, Alicia; Dahlström, Ulf; Rosano, Giuseppe; visa fler...; Lam, Carolyn S. ...; Lund, Lars H.; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: JACC. Heart fail ...

Av lärosätet: Uppsala universitet; Karolinska Institutet; Linköpings universitet

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