TY - JOUR
T1 - Heart failure with improved versus persistently reduced left ventricular ejection fraction
T2 - A comparison of the BIOSTAT-CHF (European) study with the ASIAN-HF registry
AU - Cao, Thong Huy
AU - Tay, Wan Ting
AU - Jones, Donald J.L.
AU - Cleland, John G.F.
AU - Tromp, Jasper
AU - Emmens, Johanna Elisabeth
AU - Teng, Tiew Hwa Katherine
AU - Chandramouli, Chanchal
AU - Slingsby, Oliver Charles
AU - Anker, Stefan D.
AU - Dickstein, Kenneth
AU - Filippatos, Gerasimos
AU - Lang, Chim C.
AU - Metra, Marco
AU - Ponikowski, Piotr
AU - Samani, Nilesh J.
AU - Van Veldhuisen, Dirk J.
AU - Zannad, Faiez
AU - Anand, Inder S.
AU - Lam, Carolyn S.P.
AU - Voors, Adriaan A.
AU - Ng, Leong L.
N1 - Publisher Copyright:
© 2024 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2024/8/9
Y1 - 2024/8/9
N2 - Aims: We investigated the prevalence, clinical characteristics, and prognosis of patients with heart failure (HF) with improved ejection fraction (HFimpEF). Methods and results: We used data from BIOSTAT-CHF including patients with a left ventricular ejection fraction (LVEF) ≤40% at baseline who had LVEF re-assessed at 9 months. HFimpEF was defined as a LVEF >40% and a LVEF ≥10% increase from baseline at 9 months. We validated findings in the ASIAN-HF registry. The primary outcome was a composite of time to HF rehospitalization or all-cause mortality. In BIOSTAT-CHF, about 20% of patients developed HFimpEF, that was associated with a lower primary event rate of all-cause mortality (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.28–0.97, p = 0.040) and the composite endpoint (HR 0.46, 95% CI 0.30–0.70, p < 0.001) compared with patients who remained in persistent HF with reduced ejection fraction (HFrEF). The findings were similar in the ASIAN-HF (HR 0.40, 95% CI 0.18–0.89, p = 0.024, and HR 0.29, 95% CI 0.17–0.48, p < 0.001). Five independently common predictors for HFimpEF in both BIOSTAT-CHF and ASIAN-HF were female sex, absence of ischaemic heart disease, higher LVEF, smaller left ventricular end-diastolic and end-systolic diameter at baseline. A predictive model combining only five predictors (absence of ischaemic heart disease and left bundle branch block, smaller left ventricular end-systolic and left atrial diameter, and higher platelet count) for HFimpEF in the BIOSTAT-CHF achieved an area under the curve of 0.772 and 0.688 in the ASIAN-HF (due to missing left atrial diameter and platelet count). Conclusions: Approximately 20–30% of patients with HFrEF improved to HFimpEF within 1 year with better clinical outcomes. In addition, the predictive model with clinical predictors could more accurately predict HFimpEF in patients with HFrEF.
AB - Aims: We investigated the prevalence, clinical characteristics, and prognosis of patients with heart failure (HF) with improved ejection fraction (HFimpEF). Methods and results: We used data from BIOSTAT-CHF including patients with a left ventricular ejection fraction (LVEF) ≤40% at baseline who had LVEF re-assessed at 9 months. HFimpEF was defined as a LVEF >40% and a LVEF ≥10% increase from baseline at 9 months. We validated findings in the ASIAN-HF registry. The primary outcome was a composite of time to HF rehospitalization or all-cause mortality. In BIOSTAT-CHF, about 20% of patients developed HFimpEF, that was associated with a lower primary event rate of all-cause mortality (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.28–0.97, p = 0.040) and the composite endpoint (HR 0.46, 95% CI 0.30–0.70, p < 0.001) compared with patients who remained in persistent HF with reduced ejection fraction (HFrEF). The findings were similar in the ASIAN-HF (HR 0.40, 95% CI 0.18–0.89, p = 0.024, and HR 0.29, 95% CI 0.17–0.48, p < 0.001). Five independently common predictors for HFimpEF in both BIOSTAT-CHF and ASIAN-HF were female sex, absence of ischaemic heart disease, higher LVEF, smaller left ventricular end-diastolic and end-systolic diameter at baseline. A predictive model combining only five predictors (absence of ischaemic heart disease and left bundle branch block, smaller left ventricular end-systolic and left atrial diameter, and higher platelet count) for HFimpEF in the BIOSTAT-CHF achieved an area under the curve of 0.772 and 0.688 in the ASIAN-HF (due to missing left atrial diameter and platelet count). Conclusions: Approximately 20–30% of patients with HFrEF improved to HFimpEF within 1 year with better clinical outcomes. In addition, the predictive model with clinical predictors could more accurately predict HFimpEF in patients with HFrEF.
KW - Clinical outcome
KW - Heart failure
KW - Heart failure with improved ejection fraction
KW - Heart failure with reduced ejection fraction
KW - Left ventricular ejection fraction
KW - Predictive model
KW - Predictor
UR - http://www.scopus.com/inward/record.url?scp=85200954710&partnerID=8YFLogxK
U2 - 10.1002/ejhf.3378
DO - 10.1002/ejhf.3378
M3 - Article
AN - SCOPUS:85200954710
SN - 1388-9842
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
ER -