title: Heart failure with preserved and reduced ejection fraction: different phenotypes in old-elderly patients?
abstract: BACKGROUND
  Patients with heart failure with preserved ejection fraction (HFPEF) represent an important group of patients presenting in clinical practice. However, whether it is an earlier stage of heart failure with reduced ejection fraction (HFREF) remains uncertain. We evaluated the potential progression of HFPEF to HFREF.
  
  
  RESULTS
  We evaluated retrospectively 178 patients (mean age 80.5±5.8 years; 75.3% females) with heart failure with preserved ejection fraction from a specialized Internal Medicine unit, offering an integrated usual care. Diagnosis of heart failure with preserved ejection fraction was made according to European guidelines. The main objective was to evaluate the progression to systolic dysfunction, defined by left ventricular ejection fraction less than 45%. Mean baseline left ventricular ejection fraction was 64.6±7.2. After a mean follow-up of 24-months, mean baseline ejection fraction was 67.1±9.3%. Only five patients (2.8%) progressed to HFREF. Brain natriuretic peptide values were significantly higher in those patients who progressed.
  
  
  CONCLUSIONS
  These results strongly suggest that heart failure with preserved and reduced ejection fraction could be distinct pathophysiological entities, at least in elderly patients.
authors: Department of Internal Medicine, Hospital Juan Ramón Jiménez, Huelva, Spain.
authors: María Inmaculada
authors: MI
authors: Páez-Rubio
authors: Francisco Javier
authors: FJ
authors: Carrasco-Sánchez
authors: Carlos
authors: C
authors: Escobar-Cervantes
authors: Nancy
authors: N
authors: Sánchez-Gómez
authors: José Luis
authors: JL
authors: Santiago-Ruiz
authors: Miguel
authors: M
authors: Yebra-Yebra
authors: Luis
authors: L
authors: Manzano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D045265:Natriuretic Peptides / Q000097:blood*; D010641:Phenotype; D013318:Stroke Volume / Q000502:physiology*; D018754:Ventricular Dysfunction / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D045265:Natriuretic Peptides