Abstract
Background Heart failure with mid-range ejection fraction (HFmrEF) of 40-49% is an under-recognized class of CHF. Prognosis of HFmrEF in comparison to HFrEF and HFpEF with stable EF of 1 year is unclear. Objectives We hypothesized that HFmrEF patients with stable EF of 1 year have different mortality and morbidity prognosis compared to HFrEF and HFpEF patients with stable EF of 1 year. Methods We screened 2593 baseline echo studies and evaluated their subsequent studies to identify patients with HFmrEF, HFrEF, and HFpEF and stable EF of 1 year. One-way ANOVA and chi-square tests were used to assess baseline differences. Kaplan Meier survival analysis was conducted and Log-rank p values were calculated to assess the association of every group with all-cause mortality, cardiac mortality, and HF hospitalizations. Multivariate Cox regression analysis was adjusted for age, gender, HF etiology, HTN, DM, DLP, CAD, MI, a-fib, and malignancy, and NYHA class. Results A total of 516 patients were included. Table 1 summarizes characteristics of patients. Follow up period was 62.3 ± 30.9 months. HFmrEF patients had lower HF hospitalization rate compared to HFrEF patients and higher rate compared to HFpEF patients (figure 1), p-value=0.0001. In adjusted model, the rate remained significantly lower in HFmrEF patients compared to HFrEF patients (HR = 0.5, 95% CI = 0.35-0.7, p-value = 0.0001). However, the difference between HFmrEF and HFpEF patients became insignificant. No significant differences were observed in all-cause or cardiac mortality between the 3 groups, p-value = 0.2 and p-value = 0.26 respectively. Conclusion We found that HFmrEF patients with stable EF had lower HF hospitalization rate compared to HFrEF patients. All-cause and cardiac mortality rates were similar between HFmrEF, HFrEF, and HFpEF patients with stable EF.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
