Heart failure & cardiomyopathies
Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis
Authors' conclusion
The direct effect of aetiology on mortality dominates the indirect effect through LVEF.
Study context
- Population
- Austrian patients with chronic HF (mean age 57.2 years; mean follow-up 8.8 years)
- Participants
- 2,056 patients
- Exposure
- Each aetiology vs other aetiologies
- DCMn = 1,009
- HCMn = 89
- IHDn = 529
- HHDn = 320
- Cardiac amyloidosis (CA)n = 109
- Outcome
- Overall mortality: total effect of aetiology decomposed into direct and indirect (mediated through LVEF) effects
- Follow-up
- Mean 8.8 years
Methodological detailsmultivariable-adjusted
- Multivariable-adjusted
Main finding
As reported in the abstract
Overall mortality, total effect vs respective other aetiologies
Hazard ratio (95% CI)
DCMvs other aetiologiestotal effect
0.77(0.67–0.89)
HCMvs other aetiologiestotal effect
0.47(0.25–0.88)
IHDvs other aetiologiestotal effect
1.40(1.21–1.62)
HHDvs other aetiologiestotal effect
0.79(0.67–0.95)
CAvs other aetiologiestotal effect
2.36(1.81–3.08)
CAvs other aetiologiesindirect effect (via LVEF)
0.74(0.65–0.83)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Effect of LVEF on mortality (per 5%-points lower LVEF), across aetiologiesSimilar across aetiologies | 1.07 (1.04–1.10) | |
| 0.512Hazard ratio (log scale) |
- Effect of left ventricular ejection fraction (LVEF) on mortality (per 5%-points lower LVEF), across aetiologies: interaction P=0.718
LVEF by aetiology
- HCM and CA significantly higher, IHD and DCM significantly lower LVEF vs other aetiologies
Original publication
Aetiology, ejection fraction and mortality in chronic heart failure: a mediation analysis. Heart. Published 18 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →