Heart failure & cardiomyopathies

Expanded Definition of Worsening Heart Failure: Impact on Clinical Outcomes and Quality-of-Life Assessment

JACC Heart FailPublished Secondary analysis of the REDUCE LAP-HF II randomised trial

Primary result · WHF events by levelResult — go to the resultHazard ratio 3.54 95% CI 1.83–6.87

Authors' conclusion

An expanded definition of WHF more clearly identified the treatment effect of an atrial shunt in a responder group and the negative association of WHF with change in quality of life.

Study context

Population
Patients with HF in the REDUCE LAP-HF II trial
Participants
621 patients
Comparison
Atrial shunt vs sham control procedure
Primary endpoint
Associations of an expanded WHF definition (level 1: hospitalization requiring IV diuretics; level 2: urgent outpatient encounters with diuretic intensification; level 3: nonurgent encounters with augmentation of oral diuretics) with treatment effect, mortality and change in KCCQ-Overall Summary Score
Follow-up
24 months

Primary result

WHF events by level

Hazard ratio

3.54

95% CI 1.83–6.87

P = 0.0002

Level 1 WHF vs Sham control
HR 3.54 (95% CI 1.83–6.87); P = 0.0002

As reported in the abstract

≥1 worsening heart failure (WHF) event
161 (25.9%)
Any level 1 WHF event
108 (17.4%)
Level 2 WHF event
22 (3.5%)
Only level 3 WHF events
31 (5.0%)

Original publication

Expanded Definition of Worsening Heart Failure: Impact on Clinical Outcomes and Quality-of-Life Assessment. JACC Heart Fail. Published 25 July 2025. doi:10.1016/j.jchf.2025.102571

Summarised from the published abstract; every number is checked against it

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