title: Mid-range Ejection Fraction Does Not Permit Risk Stratification Among Patients Hospitalized for Heart Failure.
abstract: OBJECTIVE
  European Society of Cardiology heart failure guidelines include a new patient category with mid-range (40%-49%) left ventricular ejection fraction (HFmrEF). HFmrEF patient characteristics and prognosis are poorly defined. The aim of this study was to analyze the HFmrEF category in a cohort of hospitalized heart failure patients (REDINSCOR II Registry).
  
  
  METHODS
  A prospective observational study was conducted with 1420 patients classified according to ejection fraction as follows: HFrEF, < 40%; HFmrEF, 40%-49%; and HFpEF, ≥ 50%. Baseline patient characteristics were examined, and outcome measures were mortality and readmission for heart failure at 1-, 6-, and 12-month follow-up. Propensity score matching was used to compare the HFmrEF group with the other ejection fraction groups.
  
  
  RESULTS
  Among the study participants, 583 (41%) had HFrEF, 227 (16%) HFmrEF, and 610 (43%) HFpEF. HFmrEF patients had a clinical profile similar to that of HFpEF patients in terms of age, blood pressure, and atrial fibrillation prevalence, but shared with HFrEF patients a higher proportion of male participants and ischemic etiology, and use of class I drugs targeting HFrEF. All other features were intermediate, and comorbidities were similar among the 3 groups. There were no significant differences in all-cause mortality, cause of death, or heart failure readmission. The similar outcomes were confirmed in the propensity score matched cohorts.
  
  
  CONCLUSIONS
  The HFmrEF patient group has characteristics between the HFrEF and HFpEF groups, with more similarities to the HFpEF group. No between-group differences were observed in total mortality, cause of death, or heart failure readmission.
authors.affiliation: Servicio de Cardiología y Unidad Coronaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. Electronic address: maria.ines.gomez.otero@sergas.es.
authors.forename: Inés
authors.initials: I
authors.lastname: Gómez-Otero
authors.affiliation: Departamento de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Andreu
authors.initials: A
authors.lastname: Ferrero-Gregori
authors.affiliation: Servicio de Cardiología y Unidad Coronaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Varela Román
authors.affiliation: Servicio de Cardiología y Unidad Coronaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Seijas Amigo
authors.affiliation: Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Domingo A
authors.initials: DA
authors.lastname: Pascual-Figal
authors.affiliation: Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Delgado Jiménez
authors.affiliation: Departamento de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Álvarez-García
authors.affiliation: Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
authors.affiliation: Departamento de Cardiología, Hospital Arnau de Vilanova, Lleida, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Worner Diz
authors.affiliation: Departamento de Cardiología, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Alonso-Pulpón
authors.affiliation: Departamento de Cardiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Cinca
authors.affiliation: Servicio de Cardiología y Unidad Coronaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Gónzalez-Juanatey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D057216:Propensity Score; D018570:Risk Assessment; D013318:Stroke Volume
keywords: Características clínicas; Clinical characteristics; Fracción de eyección intermedia; Heart failure; Insuficiencia cardiaca; Mid-range ejection fraction; Prognosis; Pronóstico