Mid-range Ejection Fraction Does Not Permit Risk Stratification Among Patients Hospitalized for Heart Failure

作者：Gomez Otero Ines^*; Ferrero Gregori Andreu; Varela Roman Alfonso; Seijas Amigo Jose; Pascual Figal Domingo A; Delgado Jimenez Juan; Alvarez Garcia Jesus; Fernandez Aviles Francisco; Worner Diz Fernando; Alonso Pulpon Luis; Cinca Juan; Ramon Gonzalez Juanatey Jose

来源：Revista Espanola de Cardiologia, 2017, 70(5): 338-346.

DOI：10.1016/j.rec.2016.11.016

• Heart failure
• Mid-range ejection fraction
• Clinical characteristics
• Prognosis

Introduction and objectives: European Society of Cardiology heart failure guidelines include a new patient category with mid-range (40%-49%) left ventricular ejection fraction (HFmrEF). HFmrEF patient characteristics and prognosis are poorly defined. The aim of this study was to analyze the HFmrEF category in a cohort of hospitalized heart failure patients (REDINSCOR II Registry).
Methods: A prospective observational study was conducted with 1420 patients classified according to ejection fraction as follows: HFrEF, < 40%; HFmrEF, 40%-49%; and HFpEF, >= 50%. Baseline patient characteristics were examined, and outcome measures were mortality and readmission for heart failure at 1-, 6-, and 12-month follow-up. Propensity score matching was used to compare the HFmrEF group with the other ejection fraction groups.
Results: Among the study participants, 583 (41%) had HFrEF, 227 (16%) HFmrEF, and 610 (43%) HFpEF. HFmrEF patients had a clinical profile similar to that of HFpEF patients in terms of age, blood pressure, and atrial fibrillation prevalence, but shared with HFrEF patients a higher proportion of male participants and ischemic etiology, and use of class I drugs targeting HFrEF. All other features were intermediate, and comorbidities were similar among the 3 groups. There were no significant differences in all-cause mortality, cause of death, or heart failure readmission. The similar outcomes were confirmed in the propensity score matched cohorts.
Conclusions: The HFmrEF patient group has characteristics between the HFrEF and HFpEF groups, with more similarities to the HFpEF group. No between-group differences were observed in total mortality, cause of death, or heart failure readmission.

• 出版日期2017-5