Heart Failure With Midrange Ejection Fraction in Patients Admitted for Acute Decompensation: A Report from the Japanese Multicenter Registry

MAKOTO TAKEI, Shun Kosaka, YASUYUKI SHIRAISHI, AYUMI GODA, Y. U.J.I. NAGATOMO, ATSUSHI MIZUNO, YASUMORI SUZINO, TAKASHI KOHNO, Keiichi Fukuda, TSUTOMU YOSHIKAWA

Research output: Contribution to journalArticle

Abstract

Background: Patients having heart failure with midrange ejection fraction (HFmrEF: 40% ≤ EF < 50%) are increasingly being considered a new subset of the population with heart failure. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. In addition, the significance of this new phenotype in hospitalized patients with acute decompensated heart failure (ADHF), another population whose prognosis has not improved, also remains poorly understood. This study aimed to describe the clinical characteristics, prognosis and treatment responses of patients with HFmrEF hospitalized for ADHF. Methods: On the basis of consecutive inpatient data from a multicenter ADHF registry, 651 of 3572 patients (17.1%) were classified as having HFmrEF. Prognostic factors predicting composite outcomes, defined as all-cause death and heart failure readmission, as well as all-cause death alone, were analyzed. Results: In the median follow-up duration of 724 days, both composite endpoints and all-cause death alone were comparable in those with heart failure with preserved ejection fraction, HFmrEF and heart failure with reduced ejection fraction. Age, anemia, hyponatremia, elevated blood urea nitrogen, chronic kidney disease, and elevated plasma brain natriuretic peptide levels were significant predictors of composite outcomes in HFmrEF. Conclusions: Roughly one-sixth of the patients with ADHF had HFmrEF. The long-term prognosis of patients with HFmrEF was not significantly different from that of patients with heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in the population with ADHF. Risk factors for adverse outcomes in HFmrEF were also similar to those for heart failure with preserved ejection fraction and HFmrEF in the hospitalized population with ADHF.

Original languageEnglish
JournalJournal of Cardiac Failure
DOIs
Publication statusPublished - 2019 Jan 1

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Registries
Heart Failure
Cause of Death
Population
Hyponatremia
Brain Natriuretic Peptide
Blood Urea Nitrogen
Chronic Renal Insufficiency
Anemia
Inpatients
Phenotype

Keywords

  • acute decompensated heart failure
  • East Asian
  • Heart failure with midrange ejection fraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Heart Failure With Midrange Ejection Fraction in Patients Admitted for Acute Decompensation : A Report from the Japanese Multicenter Registry. / TAKEI, MAKOTO; Kosaka, Shun; SHIRAISHI, YASUYUKI; GODA, AYUMI; NAGATOMO, Y. U.J.I.; MIZUNO, ATSUSHI; SUZINO, YASUMORI; KOHNO, TAKASHI; Fukuda, Keiichi; YOSHIKAWA, TSUTOMU.

In: Journal of Cardiac Failure, 01.01.2019.

Research output: Contribution to journalArticle

TAKEI, MAKOTO ; Kosaka, Shun ; SHIRAISHI, YASUYUKI ; GODA, AYUMI ; NAGATOMO, Y. U.J.I. ; MIZUNO, ATSUSHI ; SUZINO, YASUMORI ; KOHNO, TAKASHI ; Fukuda, Keiichi ; YOSHIKAWA, TSUTOMU. / Heart Failure With Midrange Ejection Fraction in Patients Admitted for Acute Decompensation : A Report from the Japanese Multicenter Registry. In: Journal of Cardiac Failure. 2019.
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title = "Heart Failure With Midrange Ejection Fraction in Patients Admitted for Acute Decompensation: A Report from the Japanese Multicenter Registry",
abstract = "Background: Patients having heart failure with midrange ejection fraction (HFmrEF: 40{\%} ≤ EF < 50{\%}) are increasingly being considered a new subset of the population with heart failure. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. In addition, the significance of this new phenotype in hospitalized patients with acute decompensated heart failure (ADHF), another population whose prognosis has not improved, also remains poorly understood. This study aimed to describe the clinical characteristics, prognosis and treatment responses of patients with HFmrEF hospitalized for ADHF. Methods: On the basis of consecutive inpatient data from a multicenter ADHF registry, 651 of 3572 patients (17.1{\%}) were classified as having HFmrEF. Prognostic factors predicting composite outcomes, defined as all-cause death and heart failure readmission, as well as all-cause death alone, were analyzed. Results: In the median follow-up duration of 724 days, both composite endpoints and all-cause death alone were comparable in those with heart failure with preserved ejection fraction, HFmrEF and heart failure with reduced ejection fraction. Age, anemia, hyponatremia, elevated blood urea nitrogen, chronic kidney disease, and elevated plasma brain natriuretic peptide levels were significant predictors of composite outcomes in HFmrEF. Conclusions: Roughly one-sixth of the patients with ADHF had HFmrEF. The long-term prognosis of patients with HFmrEF was not significantly different from that of patients with heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in the population with ADHF. Risk factors for adverse outcomes in HFmrEF were also similar to those for heart failure with preserved ejection fraction and HFmrEF in the hospitalized population with ADHF.",
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author = "MAKOTO TAKEI and Shun Kosaka and YASUYUKI SHIRAISHI and AYUMI GODA and NAGATOMO, {Y. U.J.I.} and ATSUSHI MIZUNO and YASUMORI SUZINO and TAKASHI KOHNO and Keiichi Fukuda and TSUTOMU YOSHIKAWA",
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T1 - Heart Failure With Midrange Ejection Fraction in Patients Admitted for Acute Decompensation

T2 - A Report from the Japanese Multicenter Registry

AU - TAKEI, MAKOTO

AU - Kosaka, Shun

AU - SHIRAISHI, YASUYUKI

AU - GODA, AYUMI

AU - NAGATOMO, Y. U.J.I.

AU - MIZUNO, ATSUSHI

AU - SUZINO, YASUMORI

AU - KOHNO, TAKASHI

AU - Fukuda, Keiichi

AU - YOSHIKAWA, TSUTOMU

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Patients having heart failure with midrange ejection fraction (HFmrEF: 40% ≤ EF < 50%) are increasingly being considered a new subset of the population with heart failure. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. In addition, the significance of this new phenotype in hospitalized patients with acute decompensated heart failure (ADHF), another population whose prognosis has not improved, also remains poorly understood. This study aimed to describe the clinical characteristics, prognosis and treatment responses of patients with HFmrEF hospitalized for ADHF. Methods: On the basis of consecutive inpatient data from a multicenter ADHF registry, 651 of 3572 patients (17.1%) were classified as having HFmrEF. Prognostic factors predicting composite outcomes, defined as all-cause death and heart failure readmission, as well as all-cause death alone, were analyzed. Results: In the median follow-up duration of 724 days, both composite endpoints and all-cause death alone were comparable in those with heart failure with preserved ejection fraction, HFmrEF and heart failure with reduced ejection fraction. Age, anemia, hyponatremia, elevated blood urea nitrogen, chronic kidney disease, and elevated plasma brain natriuretic peptide levels were significant predictors of composite outcomes in HFmrEF. Conclusions: Roughly one-sixth of the patients with ADHF had HFmrEF. The long-term prognosis of patients with HFmrEF was not significantly different from that of patients with heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in the population with ADHF. Risk factors for adverse outcomes in HFmrEF were also similar to those for heart failure with preserved ejection fraction and HFmrEF in the hospitalized population with ADHF.

AB - Background: Patients having heart failure with midrange ejection fraction (HFmrEF: 40% ≤ EF < 50%) are increasingly being considered a new subset of the population with heart failure. Despite recent advances in heart-failure treatment strategies, the prognosis of these patients has not improved substantially over time. In addition, the significance of this new phenotype in hospitalized patients with acute decompensated heart failure (ADHF), another population whose prognosis has not improved, also remains poorly understood. This study aimed to describe the clinical characteristics, prognosis and treatment responses of patients with HFmrEF hospitalized for ADHF. Methods: On the basis of consecutive inpatient data from a multicenter ADHF registry, 651 of 3572 patients (17.1%) were classified as having HFmrEF. Prognostic factors predicting composite outcomes, defined as all-cause death and heart failure readmission, as well as all-cause death alone, were analyzed. Results: In the median follow-up duration of 724 days, both composite endpoints and all-cause death alone were comparable in those with heart failure with preserved ejection fraction, HFmrEF and heart failure with reduced ejection fraction. Age, anemia, hyponatremia, elevated blood urea nitrogen, chronic kidney disease, and elevated plasma brain natriuretic peptide levels were significant predictors of composite outcomes in HFmrEF. Conclusions: Roughly one-sixth of the patients with ADHF had HFmrEF. The long-term prognosis of patients with HFmrEF was not significantly different from that of patients with heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in the population with ADHF. Risk factors for adverse outcomes in HFmrEF were also similar to those for heart failure with preserved ejection fraction and HFmrEF in the hospitalized population with ADHF.

KW - acute decompensated heart failure

KW - East Asian

KW - Heart failure with midrange ejection fraction

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