Predictors of cardiac function in acute heart failure patients with mid‐range ejection fraction: AURORA study

Abstract

Aim The factors correlated with prognosis in heart failure with mid‐range ejection fraction (HFmrEF) is unclear, especially for acute heart failure (AHF) with HFmrEF. Thus, we investigated the factors correlated with the improvement in the ejection fraction (EF) over 1 year in AHF patients with HFmrEF. Methods and results In Acute Heart Failure Registry in the Osaka Rosai Hospital, we examined 159 consecutive HFmrEF patients out of 1051 HF patients who were admitted to our hospital for AHF from January 2015 to December 2017. We divided them into improved EF (IM) group whose EF improved (≧10%) and non‐IM group who had no improvement. We compared the baseline characteristics, echocardiographic data, medications, examinations for ischaemia, invasive treatments, and clinical outcomes between IM group and non‐IM group. IM group consisted of 21 patients (20%). IM group had a significantly more de novo heart failure, higher serum albumin (Alb), lower EF, smaller left ventricular dimension during diastole, more frequent coronary angiogram during hospitalization, and coronary intervention. Multivariate analysis revealed that Alb, left ventricular dimension during diastole, and coronary angiogram performed during hospitalization were independently associated with the improvement in the EF. In addition, IM group had less rehospitalizations over 1 year and a greater reduction in the B‐type natriuretic peptide level during the follow‐up than non‐IM group. Conclusions In AHF patients with HFmrEF, we should evaluate for any ischaemic heart disease during hospitalization, especially in patients with non‐enlarged left ventricular and non‐reduced serum Alb. AHF patients with HFmrEF who showed improvement in the EF tended to have better prognosis than those without improvement.

A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation

“…NYHA grade, right ventricular function, left ventricular function, and LVEF were important methods to assess patient's cardiac functional status. 9,10 With the deterioration of cardiac function, the perioperative circulation support became increasingly important. 11,12 Herein, we found that the application of V-A-ECMO was associated with NYHA grade for recipients, indicating that when a decision needed to be made regarding whether or not to continue V-A-ECMO support at the end of surgery, it was easier for the clinicians to maintain the ECMO for patient with the NYHA grade of III/IV.…”

Association of Serum Albumin with Heart Failure Mortality with NYHA Class IV in Chinese Patients: Insights from PhysioNet Database

“…Most of the available evidence is focused on Europe and America, with only a few studies from Israel and Japan in Asia and little from China [18][19][20]. The relationship between serum albumin and short-term mortality is not completely clear.…”