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2017 ; 4
(2
): 99-104
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Who are patients classified within the new terminology of heart failure from the
2016 ESC guidelines?
#MMPMID28451445
Delepaul B
; Robin G
; Delmas C
; Moine T
; Blanc A
; Fournier P
; Roger-Rollé A
; Domain G
; Delon C
; Uzan C
; Boudjellil R
; Carrié D
; Roncalli J
; Galinier M
; Lairez O
ESC Heart Fail
2017[May]; 4
(2
): 99-104
PMID28451445
show ga
AIMS: The main terminology used to describe heart failure (HF) is based on
measurement of the left ventricular ejection fraction (LVEF). LVEF in the range
of 40-49% was recently defined as HF with mid-range EF (HFmrEF) by the 2016
European Society of Cardiology guidelines. The purpose of our study was to assess
the clinical profile and prognosis of patients with HF according to this new
classification. METHODS AND RESULTS: A total of 482 patients referred for HF were
retrospectively included over a period of 1 year. There were 258 (53%), 115
(24%), and 109 (23%) patients with HF with reduced EF (HFrEF), HFmrEF, and HF
with preserved EF (HFpEF), respectively. Patient age increased, whereas left
block bundle branch, brain natriuretic peptide level, and the use of beta-blocker
and furosemide decreased from HFrEF to HFpEF. After adjustment for the age,
patients with HFpEF and HFmrEF were more likely to have NYHA stage 2 dyspnea, had
a higher systolic blood pressure, were less likely to have spironolactone, had
lower furosemide dose, and had lower haemoglobin than those with HFrEF.
Cardiovascular risk factors and medical history were similar in the three groups
of patients. There was a 33% death rate after a mean follow-up of
32.2 ± 14.3 months. The survival was the same among patients whatever the group
of HF (P = 0.884). CONCLUSIONS: Patients with HFrEF, HFmrEF, and HFpEF share the
same cardiovascular risk factors, medical history, and prognosis. Patients with
HFmrEF have a different clinical profile, which is nearly the same as patients
with HFpEF, except for sex. These results question the relevance of this new
classification of HF to stimulate research into this new group of patients.