Association of Left Ventricular Ejection Fraction with Mortality and Hospitalizations

Abstract

Background: Although echocardiography is widely used to measure left ventricular ejection fraction (LVEF), its prognostic value has not been demonstrated in a broad range of patients including those acutely hospitalized for cardiac or noncardiac causes. We determined whether greater degrees of left ventricular systolic dysfunction were associated with progressively increasing risks of death or cardiovascular hospitalizations among patients in hospital or outpatient settings. Methods: A total of 27,323 patients with LVEF measured and 19,445 matched controls were followed for 223,034 person-years. Outcomes of total mortality, cardiovascular death, cardiovascular hospitalizations, and heart failure hospitalizations were examined using cause-specific hazard competing-risks analysis.

Ejection fraction and mortality: a nationwide register‐based cohort study of 499 153 women and men

“…This critical gap in the literature is particularly evident when considering the predominance of men and a lack of sex-specific data. [8][9][10] Previously, the National Echocardiography Database Australia (NEDA) 11 has identified clinically important thresholds of mortality risk in respect to pulmonary hypertension, 12 aortic stenosis 13 and, most recently, diastolic dysfunction. 14 Applying an expanded version of this unique resource, the primary aim of this study was to generate sex-specific data on the distribution of routinely observed LVEF levels and then examine their relationship to the risk of subsequent mortality.…”

Plasma microrna expression profile for reduced ejection fraction in dilated cardiomyopathy

“…Optimal pharmacological and non-pharmacological decisions, mostly based on LVEF, have improved DCM prognosis drastically 16 . Major arrhythmogenic episodes, sudden death events and mortality are related to DCM with lower EF ≤ 35% 7 . The impact of stratifying the severity of systolic impairment is crucial in DCM as shown 6 , 7 , 17 , but access to the EF has several limitations.…”

“…Major arrhythmogenic episodes, sudden death events and mortality are related to DCM with lower EF ≤ 35% 7 . The impact of stratifying the severity of systolic impairment is crucial in DCM as shown 6 , 7 , 17 , but access to the EF has several limitations. The need for expert professionals, intra- and inter-observational differences or time-consuming imaging techniques in transthoracic echocardiography or cardiac magnetic resonance, as well as inaccessible or excessive radiation imaging techniques, make it difficult to monitor the patient.…”

“…The latest guidelines have established that the systolic ejection fraction (EF) discerns between heart failure (HF) categories 4 . Left ventricular ejection fraction (LVEF) has been strongly associated with adverse cardiac outcome in DCM 5 – 7 . Severely depressed EF, below 35%, has been shown in randomized clinical trials as a sudden death risk factor 8 .…”

Echocardiography 2020: Toward deciphering the “Rosetta stone” of left ventricular diastolic function

“…As recently as only a few weeks ago, we have learned that the left ventricular ejection fraction (LVEF), a marker, though controversial, of left ventricular systolic function, may indeed predict mortality in a wide variety of population with diverse pathologies, cardiac and non‐cardiac 5 . The argument on the merit of LVEF as a measure of systolic function has grown over the years, and today, we all agree that left ventricular global longitudinal strain (LVGLS) with or without LVEF remains the marker of choice to assess LV systolic function in a wide variety of cardiac illnesses 6 .…”