Mode of Death in Heart Failure With Preserved Ejection Fraction.
Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF. Although sudden death accounted for ∼25% to 30% of deaths in trials, its definition is nonspecific; it is unclear what proportion represents arrhythmic deaths. Moving forward, reporting and definitions of modes of death must be standardized and tailored to the HFpEF population. Broad-scale systematic autopsies and long-term rhythm monitoring may clarify the underlying pathology and mechanisms driving mortal events. There is an unmet need for a longitudinal multicenter, global registry of patients with HFpEF to map its natural history.
Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts.
Muthiah
M
Vaduganathan
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Ravi B
RB
Patel
Bayer Pharma AG, Global Epidemiology, Berlin, Germany.
Alexander
A
Michel
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Sanjiv J
SJ
Shah
Dipartimento Cardiovascolare, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
Michele
M
Senni
Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Mihai
M
Gheorghiade
Division of Cardiology, Stony Brook University, Stony Brook, New York. Electronic address: javed.butler@stonybrookmedicine.edu.
Javed
J
Butler
D001145:Arrhythmias, Cardiac / Q000401:mortality; D002423:Cause of Death; D003645:Death, Sudden; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D013318:Stroke Volume / Q000502:physiology*
epidemiology; mortality; outcomes