The association of improvement in left ventricular ejection fraction with outcomes in patients with heart failure with reduced ejection fraction: data from <scp>CHAMP‐HF</scp>

DeVore, Adam D.; Hellkamp, Anne S.; Thomas, Laine; Albert, Nancy M.; Butler, Javed; Patterson, J. Herbert; Spertus, John A.; Williams, Fredonia B.; Shen, Xian; Hernandez, Adrian F.; Fonarow, Gregg C.

doi:10.1002/ejhf.2486

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…Our second study aim represented a novelty, to our knowledge, and it is probably the most important finding of our results. Previous studies have shown that patients with HFimpEF or ‘recovered’ LVEF had a better prognosis 15–23 ; but that was not the objective of the present study. Moreover, QoL was previously associated with outcomes in patients with HF 25–30 .…”

Section: Discussionmentioning

confidence: 86%

“…14 Improvement or recovery in LVEF has been associated with better clinical outcomes, including HF-related hospitalizations and survival. [15][16][17][18][19][20][21][22][23] However, the influence of LVEF improvement (or LVEF recovery) on QoL, although reported in a small number of studies, 6,[22][23][24] has not been completely established. Indeed, it has been widely reported that QoL could predict outcomes in HF.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life in patients with heart failure and improved ejection fraction: one‐year changes and prognosis

et al. 2022

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Aims The criteria for patients with heart failure (HF) and improved ejection fraction (HFimpEF) are a baseline left ventricular ejection fraction (LVEF) ≤40%, a ≥10‐point increase from baseline LVEF, and a second LVEF measurement >40%. We aimed to (i) assess patients with HF and reduced LVEF (HFrEF) at baseline and compare quality of life (QoL) changes between those that fulfilled and those that did not fulfil the HFimpEF criteria 1 year later and (ii) assess the prognostic role of QoL in patients with HFimpEF. Methods We reviewed data from a prospective registry of real‐world outpatients with HF that were assessed for LVEF and QoL at a first visit to the HF clinic and 1 year later. QoL was evaluated with the Minnesota Living with Heart Failure Questionnaire (MLWHFQ). The primary prognostic endpoint was the composite of all‐cause death or HF hospitalization. Results Baseline and 1‐year LVEF and MLWFQ scores were available for 1040 patients with an initial LVEF ≤40% (mean age, 65.2 ± 11.7 years; 75.9% men). The main aetiology was ischaemic heart disease (52.9%), and patients were mostly in New York heart Association Classes II (71.1%) and III (21.6%). At baseline, the mean LVEF was 28.5% ± 7.3, and the mean MLWHFQ score was 30.2 ± 19.5. After 1 year, the mean LVEF increased to 38.0% ± 12.2, and the MLWHFQ scores improved to 17.4 ± 16.0. In 361 patients that fulfilled the HFimpEF criteria (34.7%), significant improvements were observed in both LVEF (from 28.7% ± 6.6 to 50.9% ± 7.6, P < 0.001) and QoL (from 32.9 ± 20.6 to 16.9 ± 16.0, P < 0.001). Patients that did not fulfil the HFimpEF criteria also showed significant improvements in LVEF (from 28.4% ± 7.6 to 31.1% ± 7.9, P < 0.001) and QoL (from 28.7 ± 18.8 to 17.6 ± 15.9, P < 0.001). However, the QoL improvement was significantly higher in the HFimpEF group (−16.0 ± 23.8 vs. −11.1 ± 20.3, P = 0.001), despite the worse mean baseline MLWHFQ score, compared with the non‐HFimpEF group (P = 0.001). The 1‐year QoL was similar between groups (P = 0.50). The 1‐year MLWHFQ score was independently associated with outcomes; the hazard ratio for the composite endpoint was 1.02 (95% CI: 1.01–1.03, P = 0.006). In contrast, the QoL improvement (with a cut‐off ≥5 points) was not independently associated with the composite outcome. Conclusions Patients with HFrEF showed improved QoL after 1 year, regardless of whether they met the HFimpEF criteria. The similar 1‐year QoL perception between groups suggested that factors other than LVEF influenced QoL perception. The 1‐year QoL was superior to the QoL change from baseline for predicting prognosis in patients with HFimpEF.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Quality of life in patients with heart failure and improved ejection fraction: one‐year changes and prognosis

et al. 2022

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“…For example, Wohlfahrt et al (2022) report HF-related quality-of-life impairment after myocardial infarction. DeVore et al (2022) report the association of improvement in the left ventricular ejection fraction with outcomes in patients with HF with a reduced ejection fraction: data from CHAMP-HF. Butler et al (2022b) report health status improvements with ferric carboxymaltose in HF with reduced ejection fraction and iron deficiency.…”

Section: Discussionmentioning

confidence: 99%

Quantitative effects of sodium–glucose cotransporter-2 inhibitors dapagliflozin and empagliflozin on quality of life in heart failure patients

Wang

Zhang²,

Zhu³

et al. 2022

Front. Pharmacol.

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The aim of the present study is to investigate the quantitative effects of sodium–glucose cotransporter-2 (SGLT-2) inhibitors on the quality of life in heart failure (HF) patients. A total of 14,674 HF patients from two dapagliflozin and three empagliflozin studies is included for analysis via the nonlinear mixed-effect modeling (NONMEM) software, among which the change rate of the Kansas City Cardiomyopathy Questionnaire (KCCQ) score is used as the evaluation index. There is no significant difference in the pharmacodynamics influencing the quality of life in HF patients between the SGLT-2 inhibitors: 10 mg/day dapagliflozin and 10 mg/day empagliflozin. For the clinical summary score (CSS), total symptom score (TSS), and overall summary score (OSS), the Emax of the SGLT-2 inhibitors on the quality of life in HF patients is 3.74%, 4.43%, and 4.84%, respectively, and ET50 is 2.23, 4.37, and 7.15 weeks, respectively. In addition, the time duration of achieving 25%, 50%, 75%, and 80% Emax is 0.75, 2.23, 6.69, and 8.92 weeks for the CSS; 1.46, 4.37, 13.11, and 17.48 weeks for the TSS; and 2.39, 7.15, 21.45, and 28.6 weeks for the OSS, respectively. Therefore, to reach the plateau period (80% of Emax) of SGLT-2 inhibitors on the CSS, TSS, and OSS, 10 mg/day dapagliflozin (or 10 mg/day empagliflozin) is required to be taken for 8.92 weeks, 17.48 weeks, and 28.6 weeks, respectively. This is the first time that the quantitative effects of SGLT-2 inhibitors on the quality of life in HF patients are being explored.

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“…DeVore et al 12 . assessed the association between improvement in left ventricular ejection fraction (LVEF) and health status or clinical events among 2092 patients with chronic HF (median LVEF 30%) included in the CHAMP‐HF (Change the Management of Patients with Heart Failure) registry.…”

Section: Effects Of Treatmentsmentioning

confidence: 99%

“…DeVore et al 12 assessed the association between improvement in left ventricular ejection fraction (LVEF) and health status or clinical events among 2092 patients with chronic HF (median LVEF 30%) included in the CHAMP-HF (Change the Management of Patients with Heart Failure) registry. A ≥10% improvement in LVEF was observed in 33% of patients and was associated with better Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) overall summary score and with a reduced risk of subsequent all-cause death or HF hospitalization (adjusted hazard ratio 0.50, 95% confidence interval 0.41-0.61).…”

Section: Changes In Left Ventricular Ejection Fraction and Worsening ...mentioning

confidence: 99%

May 2022 at a glance. Focus on treatment: from epidemiologic data to randomized trials and new devices

Tomasoni

Adamo

Metra

2022

European J of Heart Fail

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The association of improvement in left ventricular ejection fraction with outcomes in patients with heart failure with reduced ejection fraction: data from CHAMP‐HF

Cited by 14 publications

References 27 publications

Quality of life in patients with heart failure and improved ejection fraction: one‐year changes and prognosis

Quality of life in patients with heart failure and improved ejection fraction: one‐year changes and prognosis

Quantitative effects of sodium–glucose cotransporter-2 inhibitors dapagliflozin and empagliflozin on quality of life in heart failure patients

May 2022 at a glance. Focus on treatment: from epidemiologic data to randomized trials and new devices

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