Heart failure & cardiomyopathies

The Risk of Death According to Left Ventricular Ejection Fraction and Right Ventricular Dilatation in 17 321 Adults with Heart Failure from 40 High-, Middle- and Low-Income Countries – A Global Congestive Heart Failure (G-CHF) Study

Eur J Heart FailPublished Prospective cohort study

Authors' conclusion

Reduced LVEF was associated with worse prognosis in ischaemic and idiopathic dilated cardiomyopathy but not in HF of other causes. RV enlargement was associated with a more marked increase in the risk of death.

Study context

Population
Patients with heart failure (HF) from 40 countries of different income levels
Participants
17,321 patients40 countries
Exposure
Left ventricular ejection fraction (LVEF) categories and right ventricular (RV) enlargement
Outcome
Death
Follow-up
Median 2.1 (2.0-4.6) years
Methodological detailsmultinational
  • Multinational

Main finding

As reported in the abstract

Hazard ratio (95% CI)P value
LVEF 40-49%vs LVEF ≥50%
0.88(0.80–0.97)
P = 0.009
LVEF 30-39%vs LVEF ≥50%
0.96(0.88–1.05)
P = 0.40
LVEF <30%vs LVEF ≥50%
1.18(1.08–1.29)
P < 0.0001
RV enlargement
1.35(1.26–1.44)
P < 0.0001

Observational data: associations, not effects.

Further findings

Death and HF hospitalization during follow-up (whole cohort)

Died
5738 (33%)
Hospitalized for HF
3569 (21%)

LVEF–death relation by HF aetiology (subgroup)

Continuous inverse association in ischaemic HF and idiopathic dilated cardiomyopathy; no association in hypertensive, valvular and other HF
  • Interaction p = 0.0010

Original publication

The Risk of Death According to Left Ventricular Ejection Fraction and Right Ventricular Dilatation in 17 321 Adults with Heart Failure from 40 High-, Middle- and Low-Income Countries – A Global Congestive Heart Failure (G-CHF) Study. Eur J Heart Fail. Published 15 December 2024. doi:10.1002/ejhf.3550

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