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Open Access 15-04-2024 | Heart Failure | Original Paper

Prognostic impact of prior LVEF in patients with heart failure with mildly reduced ejection fraction

Authors: Alexander Schmitt, Michael Behnes, Kathrin Weidner, Mohammad Abumayyaleh, Marielen Reinhardt, Noah Abel, Felix Lau, Jan Forner, Mohamed Ayoub, Kambis Mashayekhi, Ibrahim Akin, Tobias Schupp

Published in: Clinical Research in Cardiology

Abstract

Aims

As there is limited evidence regarding the prognostic impact of prior left ventricular ejection fraction (LVEF) in patients with heart failure with mildly reduced ejection fraction (HFmrEF), this study investigates the prognostic impact of longitudinal changes in LVEF in patients with HFmrEF.

Methods

Consecutive patients with HFmrEF (i.e. LVEF 41–49% with signs and/or symptoms of HF) were included retrospectively in a monocentric registry from 2016 to 2022. Based on prior LVEF, patients were categorized into three groups: stable LVEF, improved LVEF, and deteriorated LVEF. The primary endpoint was 30-months all-cause mortality (median follow-up). Secondary endpoints included in-hospital and 12-months all-cause mortality, as well as HF-related rehospitalization at 12 and 30 months. Kaplan–Meier and multivariable Cox proportional regression analyses were applied for statistics.

Results

Six hundred eighty-nine patients with HFmrEF were included. Compared to their prior LVEF, 24%, 12%, and 64% had stable, improved, and deteriorated LVEF, respectively. None of the three LVEF groups was associated with all-cause mortality at 12 (p ≥ 0.583) and 30 months (31% vs. 37% vs. 34%; log rank p ≥ 0.376). In addition, similar rates of 12- (p ≥ 0.533) and 30-months HF-related rehospitalization (21% vs. 23% vs. 21%; log rank p ≥ 0.749) were observed. These findings were confirmed in multivariable regression analyses in the entire study cohort.

Conclusion

The transition from HFrEF and HFpEF towards HFmrEF is very common. However, prior LVEF was not associated with prognosis, likely due to the persistently high dynamic nature of LVEF in the follow-up period.

Graphical Abstract

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Title: Prognostic impact of prior LVEF in patients with heart failure with mildly reduced ejection fraction
Authors: Alexander Schmitt
Michael Behnes
Kathrin Weidner
Mohammad Abumayyaleh
Marielen Reinhardt
Noah Abel
Felix Lau
Jan Forner
Mohamed Ayoub
Kambis Mashayekhi
Ibrahim Akin
Tobias Schupp
Publication date: 15-04-2024
Publisher: Springer Berlin Heidelberg
Keyword: Heart Failure
Published in: Clinical Research in Cardiology
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-024-02443-0

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Prognostic impact of prior LVEF in patients with heart failure with mildly reduced ejection fraction

Abstract

Aims

Methods

Results

Conclusion

Graphical Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

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At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Aims

Methods

Results

Conclusion

Graphical Abstract

Please log in to get access to this content

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page