Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study

Tribouilloy, Christophe; Ruşinaru, Dan; Mahjoub, Haïfa; Soulière, Vicky; Lévy, F.; Peltier, Marcel; Slama, Michel; Massy, Ziad A.

doi:10.1093/eurheartj/ehm554

Cited by 367 publications

(257 citation statements)

References 33 publications

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“…Although data regarding the prognostic implications of CAD in HFpEF are conflicting,26, 46, 47, 48 contemporary data suggest that revascularization in patients with HFpEF and CAD is associated with improved outcomes,48 an observation noted in all subgroups analyzed in our study. Thus, this study further supports the need to rigorously investigate the potential benefit of aggressive CAD screening with the intent of revascularization to improve outcomes.…”

Section: Discussionmentioning

confidence: 58%

Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction

Goyal

Paul

Almarzooq

et al. 2017

JAHA

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BackgroundSex and race have emerged as important contributors to the phenotypic heterogeneity of heart failure with preserved ejection fraction (HFpEF). However, there remains a need to identify important sex‐ and race‐related differences in characteristics and outcomes using a nationally representative cohort.Methods and ResultsData were obtained from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project—Nationwide Inpatient Sample files between 2008 and 2012. Hospitalizations with a diagnosis of HFpEF were included for analysis. Demographics, hospital characteristics, and age‐adjusted comorbidity prevalence rates were compared between men and women and whites and blacks. In‐hospital mortality was determined and compared for each subgroup. Multivariable regression analyses were used to identify and compare correlates of in‐hospital mortality for each subgroup. A sample of 1 889 608 hospitalizations was analyzed. Men with HFpEF were slightly younger than women with HFpEF and had a higher Elixhauser comorbidity score. Men experienced higher in‐hospital mortality compared with women, a finding that was attenuated after adjusting for comorbidity. Blacks with HFpEF were younger than whites with HFpEF, with lower rates of most comorbidities. Hypertension, diabetes, anemia, and chronic renal failure were more common among blacks. Blacks experienced lower in‐hospital mortality compared with whites, even after adjusting for age and comorbidity. Important correlates of mortality among all 4 subgroups included pulmonary circulation disorders, liver disease, and chronic renal failure. Atrial fibrillation was an important correlate of mortality only among women and blacks.ConclusionsDifferences in patient characteristics and outcomes reinforce the notion that sex and race contribute to the phenotypic heterogeneity of HFpEF.

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Section: Discussionmentioning

confidence: 58%

Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction

Goyal

Paul

Almarzooq

et al. 2017

JAHA

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“…Approximately half the number of patients with HF have preserved EF, with the incidence of HFpEF on the rise similar to the obesity trends. Importantly, patients with HFpEF have similar long‐term prognosis to systolic HF 30. The ‘obesity paradox’ has been reported in patients with HFrEF and HFpEF.…”

Section: Does Aetiology or Ejection Fraction Matter In ‘Obesity Paradmentioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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“…The overall prevalence of COPD in HFpEF is 30% 208. When present, COPD is an independent predictor of mortality 238. Its impact on mortality is greater in HFpEF than HFrEF 210.…”

Section: Comorbid Conditionsmentioning

confidence: 99%

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

Samson

Jaiswal

Ennezat

et al. 2016

JAHA

102

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Prognosis of heart failure with preserved ejection fraction: a 5 year prospective population-based study

Abstract: Heart failure with preserved ejection fraction has a poor prognosis, comparable with that of HF with reduced EF, with a 5 year survival rate after a first episode of 43% and a high excess mortality compared with the general population.

Cited by 367 publications

References 33 publications

Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction

Sex‐ and Race‐Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction

Obesity paradox in heart failure: a heavy matter

Clinical Phenotypes in Heart Failure With Preserved Ejection Fraction

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