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Heart failure with normal LVEF in BIOSTAT-CHF

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journal contribution
posted on 2023-01-20, 16:59 authored by Lukas Baumhove, Jasper Tromp, Sylwia Figarska, Bart J van Essen, Stefan D Anker, Kenneth Dickstein, John G Cleland, Chim C Lang, Gerasimos Filippatos, Leong L Ng, Nilesh J Samani, Marco Metra, Dirk J van Veldhuisen, Carolyn SP Lam, Adriaan A Voors, Peter van Der Meer

Aims: Several studies have shown that heart failure (HF) drug treatment seems to benefit patients with preserved ejection fraction (HFpEF) and a left ventricular ejection fraction (LVEF) up to 55–60% but not with higher LVEF. Certain HF drugs are now indicated in patients with HFpEF and a LVEF below normal. However, not much is known about patients with a normal LVEF. Therefore, we investigated the prevalence, clinical characteristics and outcome of patients with HF and a normal LVEF. 

Methods and results: Normal LVEF was defined according to the Recommendations for Cardiac Chamber Quantification from the American Society of Echocardiography as a LVEF ≥62% for men and ≥ 64% for women. Preserved ejection fraction was defined as a LVEF ≥50% and reduced ejection fraction as a LVEF <50%. In the total cohort of 1568 studied patients with heart failure (mean age 73 years; 33.6% female) 57 patients (3.6%) had a normal LVEF. These patients least likely had a previous myocardial infarction (p < 0.001) or diabetes (p = 0.045), had the lowest Left Ventricular End Diastolic Diameter (p < 0.001), the highest rate of previous HF hospitalization in the last year (p = 0.015), the highest cardiac output (p < 0.001) and were most frequently women (p < 0.001). Patients with a normal LVEF had the lowest risk for the primary combined outcome of all-cause mortality and HF hospitalization. 

Conclusion: Only 3.6% of patients with HF had a sex-adjusted normal LVEF. Despite the sex-adjusted cut-offs they were more frequently female with less ischemic heart disease, higher cardiac output and better clinical outcomes.

Funding

BIOSTAT-CHF was funded by the European Commission [FP7–242209-BIOSTAT-CHF; EudraCT 2010–020808-29].

History

Citation

Baumhove, L., Tromp, J., Figarska, S., van Essen, B. J., Anker, S. D., Dickstein, K., ... & van der Meer, P. (2022). Heart failure with normal LVEF in BIOSTAT-CHF. International Journal of Cardiology.

Author affiliation

Department of Cardiovascular Sciences; NIHR Leicester Biomedical Research Centre

Version

VoR (Version of Record)

Published in

INTERNATIONAL JOURNAL OF CARDIOLOGY

Volume

364

Pagination

85 - 90

Publisher

ELSEVIER IRELAND LTD

issn

0167-5273

eissn

1874-1754

Acceptance date

2022-05-23

Copyright date

2022

Available date

2023-01-20

Language

English