Cardiology Letters 2017, 26(4):228-235

Prognosis of heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in 3-years follow up: A comparative analysis

Cenkerová K¹, Dúbrava J², Pokorná V³, Kalužay J³, Jurkovičová O³

¹ Oddelenia všeobecnej kardiológie, Národný ústav srdcových a cievnych chorôb a. s., Bratislava

² Oddelenia neinvazívnej kardiológie, IV. interná klinika, Nemocnica sv. Cyrila a Metoda, Bratislava

³ IV. interná kliniky, Nemocnica sv. Cyrila a Metoda, Bratislava, Slovenská republika

Background: Data related to heart failure with preserved ejection fraction (HFPEF) are limited, even though the prevalence is high. Compared to heart failure with reduced ejection fraction (HFREF), prognosis is similarly poor.

Objective: The main objective of this monocentric study is to evaluate mortality and prognosis of patients with HFPEF in 3-years follow up.

Methods: A total of 109 consecutive patients (HFPEF: n=63 a HFREF: n=46) hospitalized for HF in internal department were included. They were divided into two groups: HFPEF with EF > 40% and HFREF with LVEF ≤ 40%. Each patient underwent complex examination every 6 months for 3 years.

Results: All-cause and cardiovascular mortality were similar in HFPEF vs. HFREF in 3-years follow up (35% vs. 37%, p = NS and 64% vs. 59%, p = NS, respectively). Likewise, the rate of rehospitalisation for heart failure (HF) was similar in HFPEF vs. HFREF (30% vs. 37%, p = NS, respectively). A dysfunctional right ventricle (RV) was significantly more prevalent in deceased patients with HFPEF compared to those with HFREF (40.9% vs. 17.1%, p<0.05). We also observed a trend to significantly higher level of NT-proBNP in deceased patients with HFPEF compared to patients with HFREF (4204 vs. 2622 ng/ml, p=0.059). We identified the following parameters as independent predictors of survival in HFPEF: preserved RV function (HR 0.33 95% CI 0.13-0.83, p<0.05), NT-proBNP (HR 1.007 per 100 ng/l 95% CI 1.002-1.0123, p<0.01) and BMI (HR 1.16 per 1 kg/m2 95% CI 1.06-1.27, p<0.01).

Conclusion: We did not identify any significant differences regarding 3-years all-cause and cardiovascular mortality in HFPEF compared to HFREF. The rate of rehospitalisation for HF in HFPEF vs. HFREF was also nonsignificant different. We identified preserved RV function, NT-proBNP and BMI as the main independent predictors of survival in HFPEF.

Keywords: heart failure with preserved ejection fraction; prognosis; preserved right ventricular ejection fraction; BMI; NT-proBNP

Published: April 1, 2017  Show citation