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Circulation Journal, 2019. 83, 347-356, DOI: https://doi.org/10.1253/circj.CJ-18-0543
Comparison of Characteristics and 3-Year Outcomes in Patients With Acute Heart Failure With Preserved, Mid-Range, and Reduced Ejection Fraction
Jun Hwan Cho, Won-Seok Choe; Hyun-Jai Cho; Hae-Young Lee; Jieun Jang; Sang Eun Lee; Jin-Oh Choi; Eun-Seok Jeon; Min-Seok Kim; Kyung-Kuk Hwang; Shung Chull Chae; Sang Hong Baek; Seok-Min Kang; Dong-Ju Choi; Byung-Su Yoo; Kye Hun Kim; Myeong-Chan Cho; Jae-Joong Kim; Byung-Hee Oh
Background: The clinical characteristics and outcomes of acute heart failure (AHF) according to left ventricular ejection fraction(LVEF) have not been fully elucidated, especially for patients with mid-range LVEF. We performed a comprehensive comparison ofthe epidemiology, patterns of in-hospital management, and clinical outcomes in AHF patients with different LVEF categories.
Methods and Results: The Korean Acute Heart Failure (KorAHF) registry is a prospective multicenter cohort of hospitalized AHFpatients in Korea. A total of 5,374 patients enrolled in the KorAHF registry were classified according to LVEF based on the 2016 ESCguidelines. More than half of the HF patients (58%) had reduced EF (HFrEF), 16% had mid-range EF (HFmrEF), and 25% hadpreserved EF (HFpEF). The HFmrEF patients showed intermediate epidemiological profiles between HFrEF and HFpEF and had apropensity to present as de-novo HF with ischemic etiology. Patients with lower LVEF had worse short-term outcomes, and theall-cause in-hospital mortality, including urgent heart transplantation, of HFrEF, HFmrEF, and HFpEF was 7.1%, 3.6%, and 3.0%,respectively. Overall, discharged AHF patients showed poor 3-year all-cause death up to 38%, which was comparable between LVEFsubgroups (P=0.623).
Conclusions: Each LVEF subgroup of AHF patients was a heterogeneous population with diverse characteristics, which have asignificant effect on the clinical outcomes. This finding suggested that focused phenotyping of AHF patients could help identify theoptimal management strategy and develop novel effective therapies.
- DOI: https://doi.org/10.1253/circj.CJ-18-0543
- ISBN or ISSN: 1346-9843
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.