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Temporal changes in left ventricular ejection fraction and their prognostic impacts in patients with Stage B heart failure

Authors :
Masanobu Miura
Chart Investigators
Ruri Abe
Yasuhiko Sakata
Masayuki Sato
Hideka Hayashi
Hajime Aoyanagi
Satoshi Miyata
Shintaro Kasahara
Jun Takahashi
Takahide Fujihashi
Kotaro Nochioka
Koichiro Sugimura
Shinsuke Yamanaka
Hiroaki Shimokawa
Takashi Shiroto
Source :
International Journal of Cardiology. 306:123-132
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

Background We have recently demonstrated that left ventricular ejection fraction (LVEF) dynamically changes over time with prognostic impacts in Stage C/D patients, namely, those who have a current or past history of heart failure (HF). However, it is unknown whether this is also the case in asymptomatic Stage B patients, namely, those who have a risk of HF, but do not have a history of HF. Methods In our CHART-2 Study (N = 10,219), we enrolled 4005 Stage B patients and divided them into 3 groups by LVEF; preserved EF (pEF, LVEF ≥50%, N = 3526), mid-range EF (mrEF, LVEF 41–49%, N = 302), and reduced EF (rEF, LVEF ≤40%, N = 177). We examined the prognostic impacts of LVEF transitions among the 3 groups in comparison with 4477 patients with Stage C/D HF. Results Stage B were characterized by less severe clinical status and better prognosis compared with Stage C/D. Stage B in mrEF and rEF at baseline dynamically transitioned to other groups at 1-year, whereas those in pEF unchanged; at 1-year, mrEF transitioned to pEF/rEF by 50/16%, and rEF transitioned to pEF/mrEF by 25/31%, respectively, whereas pEF transitioned to mrEF/rEF by only 3.6/0.7%, respectively, which were consistent with findings in findings with Stage C/D. Although LVEF decrease was directly associated with all-cause mortality in both the Stage B and Stage C/D with pEF, factors related to LVEF changes were different between the 2 groups. Conclusions In Stage B, LVEF dynamically changes with prognostic impacts as in Stage C/D, whereas different determination factors may be involved in the 2 stages. Clinical trial registration: Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-2 (NCT00418041).

Details

ISSN :
01675273
Volume :
306
Database :
OpenAIRE
Journal :
International Journal of Cardiology
Accession number :
edsair.doi.dedup.....ab5a6f8aee0b9b0971483478ad2a2634
Full Text :
https://doi.org/10.1016/j.ijcard.2020.02.040