title: Ultrafiltration in heart failure with preserved ejection fraction: comparison with systolic heart failure patients.
abstract: BACKGROUND
  Ultrafiltration (UF) is a widely used technology for inpatient management of acute decompensated heart failure in patients with volume overload. However, the safety and efficacy of UF in patients with heart failure and preserved left ventricular ejection fraction (heart failure with preserved ejection fraction [HFPEF]) need further clarification. We hypothesized that UF could be used in this population with outcomes similar to acute decompensated heart failure patients with low left ventricular ejection fraction (HFLEF).
  
  
  RESULTS
  Prospective evaluation was performed on 2 patient cohorts admitted to a single institution for acute decompensated heart failure and treated with UF: HFLEF (left ventricular ejection fraction ≤ 40%; n=87) and HFPEF (left ventricular ejection fraction >40%; n=97). Selected demographic and clinical data were compared, including clinical and serological information, as well as in-hospital and 90-day postdischarge mortality. HFPEF patients were more likely to be women, have higher blood pressures, and less likely to have ischemic heart disease. There were no significant differences in total weight loss (7.7% in HFLEF and 7.0% in HFPEF), electrolyte and renal disturbances, or in-hospital mortality (3.4% in HFLEF and 3.3% in HFPEF) between the 2 groups. Mortality at 90 days tended to be greater in HFLEF (24.1%) than in HFPEF (15.5%).
  
  
  CONCLUSIONS
  Therapeutic responses in patients with HFPEF meeting current indication for UF are similar to those with HFLEF. Larger studies are warranted to better characterize acute heart failure management with UF in this population.
authors.affiliation: Heart and Vascular Center at The Christ Hospital, Cincinnati, OH, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Jefferies
authors.forename: Cheryl
authors.initials: C
authors.lastname: Bartone
authors.forename: Santosh
authors.initials: S
authors.lastname: Menon
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Egnaczyk
authors.forename: Thomas M
authors.initials: TM
authors.lastname: O'Brien
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Chung
mesh_terms: D000368:Aged; D001835:Body Weight; D004232:Diuretics / Q000008:administration & dosage; D005260:Female; D005665:Furosemide / Q000008:administration & dosage; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013318:Stroke Volume; D013599:Systole / Q000502:physiology; D014462:Ultrafiltration; D016277:Ventricular Function, Left
chemical_list: D004232:Diuretics; D020097:Natriuretic Peptide, Brain; D005665:Furosemide
keywords: heart failure; heart failure, diastolic; registries; ultrafiltration