title: Diagnosis, Clinical Course, and 1-Year Outcome in Patients Hospitalized for Heart Failure With Preserved Ejection Fraction (from the Polish Cohort of the European Society of Cardiology Heart Failure Long-Term Registry).
abstract: Compared with heart failure (HF) with reduced ejection fraction (HF-REF), the diagnosis of HF with preserved EF (HF-PEF) is more challenging. The aim of the study was to assess the prevalence of HF-PEF among patients hospitalized for HF, to evaluate the pertinence of HF-PEF diagnosis and to compare HF-PEF and HF-REF patients with respect to outcomes. The analysis included 661 Polish patients hospitalized for HF, selected from the European Society of Cardiology (ESC)-HF Long-Term Registry. Patients with an EF of ≥50% were included in the HF-PEF group and patients with an EF of <50% - in the HF-REF group. The primary end point was all-cause death at 1 year. The secondary end point was a composite of all-cause death and rehospitalization for HF at 1 year. HF-PEF was present in 187 patients (28%). Of those 187 patients, mitral inflow pattern was echocardiographically assessed in 116 patients (62%) and classified as restrictive/pseudonormal in 37 patients (20%). Compared with HF-REF subjects, patients with HF-PEF were older, more often female, and had a higher prevalence of hypertension, atrial fibrillation and sleep apnea. Despite lower B-type natriuretic peptide concentrations and lower prevalence of moderate-to-severe mitral regurgitation in patients with HF-PEF, congestive symptoms at admission were as severe as in patients with HF-REF. There were no significant differences in in-hospital mortality between the HF groups. One-year mortality was high in both groups (17% in HF-PEF vs 21% in HF-REF, p = 0.22). There was a trend toward a lower frequency of the secondary end point in the HF-PEF group (32% vs 40%, p = 0.07). In conclusion, in clinical practice, even easily obtainable echocardiographic indexes of diastolic dysfunction are relatively rarely acquired. One-year survival rate of patients with HF-PEF is not significantly better than that of patients with HF-REF.
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. Electronic address: agnieszka.kaplon@gmail.com.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kapłon-Cieślicka
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Agata
authors.initials: A
authors.lastname: Tymińska
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Peller
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ozierański
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Michalina
authors.initials: M
authors.lastname: Galas
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Marchel
authors.affiliation: Complexo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Crespo-Leiro
authors.affiliation: Centro Studi ANMCO (Associazione Nazionale Medici Cardiologi Ospedalieri), Florence, Italy.
authors.forename: Aldo Pietro
authors.initials: AP
authors.lastname: Maggioni
authors.affiliation: Department of Cardiology, First Chair of Cardiology and Cardiac Surgery, Medical University of Łódź, Łódź, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Drożdż
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.affiliation: First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011044:Poland; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D012720:Severity of Illness Index; D017678:Sex Distribution; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D013318:Stroke Volume
chemical_list: D020097:Natriuretic Peptide, Brain