In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Clinical phenotype and short-term outcome of acute heart failure in patients with mid-range ejection fraction: a prospective cohort study

Session Poster Session 3

Speaker Selin Atesler

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : S Atesler (Metz,FR), N Zannad (Metz,FR), K Khalife (Metz,FR), M Benichou (Metz,FR), C Goetz (Metz,FR), A Olivier (Nancy,FR)

Authors:
S Atesler1 , N Zannad1 , K Khalife1 , M Benichou1 , C Goetz1 , A Olivier2 , 1Regional hospital Center of Metz-Thionville, Cardiology - Metz - France , 2University Hospital of Nancy - Nancy - France ,

Citation:

INTRODUCTION: Acute heart failure (AHF) has an unfavourable prognosis in both reduced (HFrEF) and preserved ejection fraction (HFpEF). Current guidelines define heart failure with mid-range ejection fraction (HFmrEF) as a new category to further investigate. Few data are yet available for patients with AHF and mid-range ejection fraction.

PURPOSE : We aimed to define the clinical and biological phenotype, the differences in therapies, the in-hospital management and outcome, and the short-term prognosis of patients hospitalized for AHF with HFmrEF compared to HFrEF and HFpEF. 

METHODS: We include prospectively all consecutive patients hospitalized for AHF in our Heart Failure Unit, between February and December 2017. Clinical and biological phenotype, differences in therapies, in-hospital management and outcome of patients with HFmrEF were compared to HFrEF and HFpEF. The primary endpoint was the composite criteria of all- cause death or heart failure related hospitalization 3 months after discharge. 

RESULTS: From 245 patients included, 102 (41.6%) had HFrEF, 37 (15.1%) HFmrEF, and 106 (43.3%) HFpEF. HFmrEF resembled HFrEF with more ischemic heart disease (55%), lower body mass index (26.2±5.8 kg/m2) and resembled HFpEF with older subjects (80.0±9.0 years) and more hypertension (70%). We found a decreasing gradient of BNP from HFrEF to HFpEF. First line guideline-directed therapies were similarly increased in all groups. Groups were not significantly different for the primary endpoint with 35.0%, 27.5% and 38.0% for HFrEF, HFmrEF and HFpEF respectively (p=0.49) in univariate analysis and neither for the event-free survival in multivariate analysis (p=0.62).  CONCLUSION: HFmrEF patients have a distinct phenotype but a similar adverse short- term prognosis in AHF. Left ventricular ejection fraction solely might be insufficient to assess outcome in AHF. Other variables might be considered.

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are