Comparative Analysis of Short-Term Outcomes of Patients With Heart Failure With a Mid-Range Ejection Fraction After Acute Decompensation

A comprehensive characterization of acute heart failure with preserved versus mildly reduced versus reduced ejection fraction – insights from the ESC‐HFA EORP Heart Failure Long‐Term Registry

“…In‐hospital mortality was higher in HFrEF (3.4%), with no difference between HFpEF (2.2%) and HFmrEF (2.1%). This is consistent with most previous registries, although single studies have suggested similar in‐hospital or short‐term mortality in all three EF categories 15–23 . Overall, in‐hospital mortality in our mostly European cohort was low and comparable to previous large, American AHF registries (OPTIMIZE‐HF, ADHERE, GWTG‐HF) 15–17 .…”

“…All-cause mortality at 12 months was 16% for HFpEF (95% CI 14-18), 15% for HFmrEF (95% CI 13-18), and 20% for HFrEF (95% CI [18][19][20][21][22]. First HF rehospitalization at 12-month follow-up was 16% for HFpEF (95% CI 13-18), 18% for HFmrEF (95% CI 15-21), and 25% for HFrEF (95% CI [23][24][25][26][27]. All-cause death or first HF rehospitalization at 12 months was 27% for HFpEF (95% CI 24-30), 29% for HFmrEF (95% CI 25-32), and 39% for HFrEF (95% CI 37-41).…”

“…The proportions of different EF categories were HFrEF 53%, HFmrEF 18%, and HFpEF 29%, consistent with previous AHF studies, with HFrEF proportions ranging from 36% to 66%, HFpEF from 17% to 43%, and HFmrEF from 13% to 25%. [15][16][17][18][19][20][21][22] In AHF diagnosed in emergency departments, HFpEF may be more common (64% in one study 23 ). In chronic HF, there is considerable variability, but overall proportions appear similar.…”

Heart Failure With Mid-range Ejection Fraction: A Distinctive Subtype or a Transitional Stage?

“…In current studies on HFmrEF patients with AHF, the proportions of HFmrEF patients were ~14–25% ( 20 , 36 , 98 ). These patients demonstrated intermediate features between HFrEF patients and HFpEF patients.…”

“…In terms of patients with acute HF, short-term mortality was lower in patients with HFmrEF or HFpEF, compared with patients with HFrEF in the ALARM-HF study ( 20 ). However, in another study of patients suffering from acute decompensatory HF, patients with HFmrEF had similar short-term outcomes compared with those of other categories ( 36 ).…”