Heart failure & cardiomyopathies
Unfavourable outcomes in patients with heart failure with higher preserved left ventricular ejection fraction
Authors' conclusion
A higher LVEF is independently related to poor prognosis in patients with HFpEF, in addition to concurrent AF and an elevated E/e' ratio. ACEI/ARB use, in contrast, was associated with improved prognosis, especially with regard to readmission due to HF.
Study context
- Population
- Patients admitted for decompensated heart failure (HF) with left ventricular ejection fraction (LVEF) > 40% at discharge
- Participants
- 255 patients
- Exposure
- Higher vs lower LVEF in HF with preserved ejection fraction (HFpEF)
- Outcome
- Composite of:
- All-cause death
- HF readmission
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
All-cause death and HF readmission (multivariable parametric survival analysis)
LVEF, HR per 1% increase
1.046
P = 0.001
Concurrent atrial fibrillation (AF), HR
3.203
P < 0.001
E/e', HR per 1.0 increase
1.083
P < 0.001
LVEF threshold identifying patients prone to primary endpoint
≥57.2%
Observational data: associations, not effects.
Secondary outcomes
HF readmission
- ACEi/angiotensin receptor blocker (ARB) use, HR
- 0.451 (P = 0.008)
- In addition to LVEF, AF and E/e'
Prevalence of AF or E/e' ratio by LVEF category
- No significant difference between LVEF ≥ 58% and 40% < LVEF < 58%
Original publication
Unfavourable outcomes in patients with heart failure with higher preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. Published 5 December 2022. doi:10.
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