Heart failure with recovered ejection fraction (HFrecEF): A new entity with improved cardiac outcome.

Abstract

BACKGROUND:

Aim of the study was a better characterization of heart failure (HF) with recovered ejection fraction (HFrecEF) and undulating EF (HFuEF) with regard to re-hospitalization due to congestive HF (CHF), adequate electric therapies (AETs) and mortality compared to HF with reduced EF (HFrEF), mid-range EF (HFmrEF) and preserved EF (pEF).

METHODS:

Retrospective study of 342 participants with an implantable cardioverter defibrillator (ICD) for primary or secondary prevention. Type of HF was classified according to left ventricular EF with 4.7 ± 3.1 investigations for each patient.

RESULTS:

Re-hospitalization due to CHF was similar in HFrecEF (7 (9.5%)), HFmrEF (2(9.0%)) and pEF (8(12.9%); p = n.s.) and significantly higher in HFrEF (62(38.0%)) and HFuEF (6(28.6%); p < .001 compared to HFrecEF and HFrEF). AETs were significantly lower in HFrecEF (13(17.6%)) compared to HFrEF (57(35.0%)), HFmrEF (7(31.8%)), pEF (18(29.0%)) and HFuEF (6(28.6%); each p < .01 compared to HFrecEF). Mortality was similar in HFrecEF (6(8.1%)) compared to HFuEF (0(0%)), pEF (4(6.5%)) and HFmrEF (2(9.0%), p = n.s.) and significantly lower compared to HFrEF (52(31.9%), p < .001). HFrEF was the strongest predictor for mortality besides age and chronic renal insufficiency according to Cox Regression (each p < .05) opposite to arterial hypertension, diabetes, type of cardiomyopathy and secondary prevention ICD indication (each p = n.s.).

CONCLUSIONS:

HFrecEF indicates as a new entity of HF with similar prognosis as pEF and HFmrEF with regard to re-hospitalization due to CHF and mortality and even better prognosis with regard to AETs. HFuEF showed similar rates of re-hospitalization due to CHF and AETs compared to HFrEF, but lower rates of mortality.

• Authors: Judith Zeller, Ute Hubauer, Andreas Schober, Alexander Schober, Andreas Keyser, Sabine Fredersdorf, Ekrem Uecer, Lars S Maier, Carsten Jungbauer
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 44 Issue 12 Pg. 2015-2023 (Dec 2021) ISSN: 1540-8159 [Electronic] United States
• PMID: 34687476 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.

Topics

• Aged
• Defibrillators, Implantable
• Female
• Germany
• Heart Failure (mortality, therapy)
• Humans
• Male
• Middle Aged
• Patient Readmission (statistics & numerical data)
• Primary Prevention
• Prognosis
• Retrospective Studies
• Secondary Prevention
• Stroke Volume