Long Term Prognosis of Chronic Heart Failure  Reduced vs Preserved Left Ventricular Ejection Fraction

Miyagishima, Kenji; Hiramitsu, Shinya; Kimura, Hisashi; Mori, Kensaku; Ueda, Tomoya; Kato, Shigeru; Kato, Yasuchika; Ishikawa, Shiho; Iwase, Masatsugu; Morimoto, Shin-ichiro

doi:10.1253/circj.cj-07-1016

Cited by 38 publications

(19 citation statements)

References 38 publications

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“…Data regarding this is limited. A recent study showed that the cause of death was due to heart failure in 46% of these patients, a percentage that was not significantly different from patients with reduced function [24]. Although the clinical characteristics of patients with preserved LVF are quite distinct from patients with reduced LVF, the clinical syndromes are very similar.…”

Section: Discussionmentioning

confidence: 93%

Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

et al. 2012

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BackgroundPatients with heart failure (HF) have a poor prognosis. The proportion of patients with HF and preserved left ventricular function (LVF) is increasing. Long term prognosis of HF with preserved LVF may not be so benign.ObjectivesTo evaluate the long term clinical outcome of patients with HF and preserved LVF and predictors of outcome.MethodsWe prospectively evaluated 309 patients hospitalized with a definite clinical diagnosis of HF. Patients were followed for a mean of 6.5 years for clinical outcome.ResultsMore than a third (36%) of the patients had preserved systolic LVF based on echocardiography. The long term survival rate in this group was poor and not significantly different from patients with reduced LVF (28% vs 23% respectively, P = 0.2). The adjusted survival rate by Cox regression analysis was also not significantly different (hazard ratio 1.16, 95% confidence interval 0.87–1.55, P = 0.31). The event free survival from death or heart failure re-hospitalization was also low in both groups and not significantly different between patients with preserved vs. reduced LVF (12% vs. 10% respectively, P = 0.2). Predictors of mortality in patients with preserved LVF were age, functional capacity and serum urea levels.ConclusionsThe long term clinical outcome of patients with heart failure and preserved LVF is poor and not significantly different from patients with reduced LVF.

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Section: Discussionmentioning

confidence: 93%

Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

et al. 2012

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“…There is growing recognition that among patients with clinical syndromes associated with heart failure, approximately half have preserved left ventricular systolic function, known as heart failure with preserved ejection fraction (HFpEF) [1]. Clinical evidence suggests that the morbidity and mortality rates associated with HFpEF are high and almost equal to those associated with heart failure with reduced ejection fraction (HFrEF) [2]. Recent clinical studies have provided sufficient data to help develop standardized diagnostic criteria to define HFpEF [3,4].…”

Section: Introductionmentioning

confidence: 99%

Decreased Circulating Endothelial Progenitor Cell Levels in Patients with Heart Failure with Preserved Ejection Fraction

Chiang

Huang

Leu³

et al. 2013

Cardiology

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Objectives: The purpose of this study was to explore the relationship between endothelial progenitor cell (EPC) levels, heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Methods: A total of 44 HFpEF patients, 40 HFrEF patients and 69 age-, gender- and comorbidity-matched controls were enrolled after evaluating their clinical manifestations and echocardiography findings. Flow cytometry with quantification of three EPC markers in peripheral blood samples was used to assess the number of circulating EPCs. Results: HFpEF and HFrEF patients had significantly decreased circulating EPC levels compared to controls. Among heart failure patients, patients with New York Heart Association functional class (FC) IV had fewer circulating EPCs compared to those with FC II and FC III (p = 0.053). A simple linear regression analysis of data showed that high sensitivity C-reactive protein, left ventricular ejection fraction, left atrium diameter and the ratio of medial early filling to early diastolic mitral annular velocity all correlated with the EPC count. In multivariate Cox regression analyses, both HFpEF and HFrEF were found to be independent predictors of a decreased EPC number. Conclusions: HFpEF and HFrEF patients have decreased circulating EPC numbers, which is an indication of impaired endothelial turnover.

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“…It was found that patients in normal left ventricular ejection fraction group and lower left ventricular ejection fraction group have similar prognosis in previous epidemiological investigations and observational studies [20]. But most of those experiment objects have dilated cardiomyopathy, and hypertensive heart disease patients take low proportion in patients with CAD.…”

Section: Discussionmentioning

confidence: 85%

Analysis on Outcome of 3537 Patients with Coronary Artery Disease: Integrative Medicine for Cardiovascular Events

Gao

Qiu

Yang

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Aims. To investigate the treatment of hospitalized patients with coronary artery disease (CAD) and the prognostic factors in Beijing, China. Materials and Methods. A multicenter prospective study was conducted through an integrative platform of clinical and research at 12 hospitals in Beijing, China. The clinical information of 3537 hospitalized patients with CAD was collected from September 2009 to May 2011, and the efficacy of secondary prevention during one-year followup was evaluated. In addition, a logistic regression analysis was performed to identify some factors which will have independent impact on the prognosis. Results. The average age of all patients was 64.88 ± 11.97. Of them, 65.42% are males. The medicines for patients were as follows: antiplatelet drugs accounting for 91.97%, statins accounting for 83.66%, β-receptor blockers accounting for 72.55%, ACEI/ARB accounting for 58.92%, and revascularization (including PCI and CABG) accounting for 40.29%. The overall incidence of cardiovascular events was 13.26% (469/3537). The logistic stepwise regression analysis showed that heart failure (OR, 3.707, 95% CI = 2.756–4.986), age ≥ 65 years old (OR, 2.007, 95% CI = 1.587–2.53), and myocardial infarction (OR, 1.649, 95% CI = 1.322–2.057) were the independent risk factors of others factors for cardiovascular events that occurred during followup of one-year period. Integrative medicine (IM) therapy showed the beneficial tendency for decreasing incidence of cardiovascular events, although no statistical significance was found (OR, 0.797, 95% CI = 0.613~1.036). Conclusions. Heart failure, age ≥ 65 years old, and myocardial infarction were associated with an increase in incidence of cardiovascular events, and treatment with IM showed a tendency for decreasing incidence of cardiovascular events.

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Long Term Prognosis of Chronic Heart Failure Reduced vs Preserved Left Ventricular Ejection Fraction

Cited by 38 publications

References 38 publications

Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

Decreased Circulating Endothelial Progenitor Cell Levels in Patients with Heart Failure with Preserved Ejection Fraction

Analysis on Outcome of 3537 Patients with Coronary Artery Disease: Integrative Medicine for Cardiovascular Events

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