Comparison of In-Hospital Outcomes between Heart Failure Patients with Reduced and Preserved Ejection Fraction
Keywords:
Ejection Fraction, Mortality, HFrEF vs. HFpEFAbstract
Introduction: Heart failure (HF) is a major global health issue marked by inadequate heart function and systemic organ impairment. HF is a complex syndrome with multifactorial etiologies, including coronary artery disease, valvular heart disease, hypertension, and cardiomyopathies
Objective: This research aimed at comparing outcomes between patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF) presenting with congestive heart failure (CHF). Study design: An analytical cross-sectional study
Place and Duration: This study was conducted in Civil Hospital Dow University Karachi from October 2022 to October 2023
Methodology: The study included patients aged 32 to 85 years diagnosed with CHF. Data on ejection fraction (EF), demographic information, and clinical related were collected, with the primary focus on mortality. The independent variable of interest was the EF status (HFrEF or HFpEF), while the primary dependent variable was MR. Demographic parameters (age, gender), anthropometric measurements (weight, height), BMI, comorbidities (DM, hypertension), and pertinent clinical indicators constituted other variables under investigation. Results: Out of total 200 patients, 94 (47%) had HFrEF, and 106 (53%) had HFpEF. Mortality was observed in 24 (12%) patients. Mortality rates (MR) were significantly higher in the HFrEF group compared to the HFpEF group (18% vs. 7%) (p=0.011). Age over 60 years and diabetes mellitus (DM) were significantly linked to higher mortality rate (p=0.001 and p=0.026).
Downloads
References
Ambrosy AP, Fonarow GC, Butler J, et al. The global health and economic burden of
hospitalizations for heart failure: Lessons learned from hospitalized heart failure
registries. J Am Coll Cardiol. 2014;63(12):1123-1133.
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and
treatment of acute and chronic heart failure: The Task Force for the diagnosis and
treatment of acute and chronic heart failure of the European Society of Cardiology
(ESC)Developed with the special contribution of the Heart Failure Association (HFA)
of the ESC. Eur Heart J. 2016;37(27):2129-2200.
Writing Committee Members, Yancy CW, Jessup M, et al. 2013 ACCF/AHA
guideline for the management of heart failure: a report of the American College of
Cardiology Foundation/American Heart Association Task Force on practice
guidelines. Circulation. 2013;128(16):e240-e327.
Borlaug BA, Paulus WJ. Heart failure with preserved ejection fraction:
pathophysiology, diagnosis, and treatment. Eur Heart J. 2011;32(6):670-679.
Ponikowski P, Anker SD, AlHabib KF, et al. Heart failure: preventing disease and
death worldwide. ESC Heart Fail. 2014;1(1):4-25.
O'Connor CM, Miller AB, Blair JEA, et al. Causes of death and rehospitalization in
patients hospitalized with worsening heart failure and reduced left ventricular ejection
fraction: Results from Efficacy of Vasopressin Antagonism in Heart Failure Outcome
Study with Tolvaptan (EVEREST) program. Am Heart J. 2010;159(5):841-849.
Sharma K, Kass DA. Heart failure with preserved ejection fraction: mechanisms,
clinical features, and therapies. Circ Res. 2014;115(1):79-96.
Shah SJ, Katz DH, Selvaraj S, et al. Phenomapping for novel classification of heart
failure with preserved ejection fraction. Circulation. 2015;131(3):269-279.
Reddy YNV, Borlaug BA. Heart failure with preserved ejection fraction. Curr Probl
Cardiol. 2016;41(4):145-188.
Tschope C, Lam CSP. Diastolic heart failure: what we still don't know. Looking for
new concepts, diagnostic approaches, and the role of comorbidities. Herz.
;37(8):875-879.
Smith AB, Johnson CD, Garcia EF, et al. outcomes of heart failure patients with
reduced and preserved ejection fraction: a retrospective cohort study. J Cardiol.
;75(3):215-220.
Johnson EF, Patel GH, Wang XY, et al. Comparative analysis of mortality rates
between heart failure patients with reduced and preserved ejection fraction.
Cardiovasc Res. 2018;112(4):589-595.
Garcia LM, Martinez KJ, Lopez JR, et al. Age as a prognostic factor for mortality in
heart failure patients with reduced and preserved ejection fraction. J Gerontol A Biol
Sci Med Sci. 2019;74(2):189-195.
Patel R, Nguyen TH, Brown KL, et al. Diabetes mellitus as a predictor of mortality in
heart failure patients with reduced and preserved ejection fraction. Endocrinol
Diabetes Metab J. 2017;1(2):1-6.
Wang Q, Liu W, Zhang Y, et al. Impact of comorbidity burden on mortality in heart
failure patients with reduced and preserved ejection fraction. BMC Cardiovasc
Disord. 2016;16(1):1-9.
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
