Heart failure with midrange ejection fraction: Prior left ventricular ejection fraction and prognosis

Journal article


Zhang, Xinxin, Sun, Yuxi, Zhang, Yanli, Chen, Feifei, Zhang, Shuyuan, He, Hongyan, Song, Shuang, Tse, Gary and Liu, Ying 2021. Heart failure with midrange ejection fraction: Prior left ventricular ejection fraction and prognosis. Frontiers in Cardiovascular Medicine. 8, p. 697221. https://doi.org/10.3389/fcvm.2021.697221
AuthorsZhang, Xinxin, Sun, Yuxi, Zhang, Yanli, Chen, Feifei, Zhang, Shuyuan, He, Hongyan, Song, Shuang, Tse, Gary and Liu, Ying
Abstract Evidence-based guidelines for heart failure management depend mainly on current left ventricular ejection fraction (LVEF). However, fewer studies have examined the impact of prior LVEF. Patients may enter the heart failure with midrange ejection fraction (HFmrEF) category when heart failure with preserved ejection fraction (HFpEF) deteriorates or heart failure with reduced ejection fraction (HFrEF) improves. In this study, we examined the association between change in LVEF and adverse outcomes. HFmrEF patients with at least two or more echocardiograms 3 months apart at the First Affiliated Hospital of Dalian Medical University between September 1, 2015 and November 30, 2019 were identified. According to the prior LVEF, the subjects were divided into improved group (prior LVEF < 40%), stable group (prior LVEF between 40 and 50%), and deteriorated group (prior LVEF ≥ 50%). The primary outcomes were cardiovascular death, all-cause mortality, hospitalization for worsening heart failure, and composite event of all-cause mortality or all-cause hospitalization. A total of 1,168 HFmrEF patients (67.04% male, mean age 63.60 ± 12.18 years) were included. The percentages of improved, stable, and deteriorated group were 310 (26.54%), 334 (28.60%), and 524 (44.86%), respectively. After a period of follow-up, 208 patients (17.81%) died and 500 patients met the composite endpoint. The rates of all-cause mortality were 35 (11.29%), 55 (16.47%), and 118 (22.52%), and the composite outcome was 102 (32.90%), 145 (43.41%), and 253 (48.28%) for the improved, stable, and deteriorated groups, respectively. Cox regression analysis showed that the deterioration group had higher risk of cardiovascular death (HR: 1.707, 95% CI: 1.064-2.739, = 0.027), all-cause death (HR 1.948, 95% CI 1.335-2.840, = 0.001), and composite outcome (HR 1.379, 95% CI 1.096-1.736, = 0.006) compared to the improvement group. The association still remained significant after fully adjusted for both all-cause mortality (HR = 1.899, 95% CI 1.247-2.893, = 0.003) and composite outcome (HR: 1.324, 95% CI: 1.020-1.718, = 0.035). HFmrEF patients are heterogeneous with three different subsets identified, each with different outcomes. Strategies for managing HFmrEF should include previously measured LVEF to allow stratification based on direction changes in LVEF to better optimize treatment. [Abstract copyright: Copyright © 2021 Zhang, Sun, Zhang, Chen, Zhang, He, Song, Tse and Liu.]
KeywordsPrognosis; Heart failure; Mid-range ejection fraction; Left ventricular ejection fraction; Cardiology
Year2021
JournalFrontiers in Cardiovascular Medicine
Journal citation8, p. 697221
PublisherFrontiers Media S.A.
ISSN2297-055X
Digital Object Identifier (DOI)https://doi.org/10.3389/fcvm.2021.697221
Official URLhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.697221/full
Publication dates
Online02 Aug 2021
Publication process dates
Accepted29 Jun 2021
Deposited06 Sep 2021
Publisher's version
License
File Access Level
Open
Output statusPublished
Permalink -

https://repository.canterbury.ac.uk/item/8y6xz/heart-failure-with-midrange-ejection-fraction-prior-left-ventricular-ejection-fraction-and-prognosis

Download files


Publisher's version
fcvm-08-697221.pdf
License: CC BY 4.0
File access level: Open

  • 15
    total views
  • 7
    total downloads
  • 3
    views this month
  • 1
    downloads this month

Export as

Related outputs

A remote mentorship model for empowering students to undertake electrocardiology research: Effects on gender equity.
Nam, Ronald Hang Kin, Tse, Gary, Liu, Tong, Jeevaratnam, Kamalan and Lee, Sharen 2022. A remote mentorship model for empowering students to undertake electrocardiology research: Effects on gender equity. Journal of Electrocardiology. 72, pp. 128-130. https://doi.org/S0022-0736(22)00058-9
Editorial: Risk stratification strategies for cardiac rhythm abnormalities
Tse, Gary, Zhang, Nan, Song, Wenhua, Letsas, Konstantinos P., Ngarmukos, Tachapong, Jeevaratnam, Kamalan and Liu, Tong 2022. Editorial: Risk stratification strategies for cardiac rhythm abnormalities. Frontiers in Cardiovascular Medicine. 9, p. 887461. https://doi.org/10.3389/fcvm.2022.887461
C-reactive protein and atrial fibrillation: Insights from epidemiological and Mendelian randomization studies.
Li, Xintao, Peng, Shi, Wu, Xiaoyu, Guan, Bo, Tse, Gary, Chen, Songwen, Zhou, Genqing, Wei, Yong, Gong, Chao, Lu, Xiaofeng, Xu, Juan, Wu, Shouling and Liu, Shaowen 2022. C-reactive protein and atrial fibrillation: Insights from epidemiological and Mendelian randomization studies. Nutrition, metabolism, and cardiovascular diseases : NMCD. https://doi.org/S0939-4753(22)00130-2
Pathogenesis and management of Brugada Syndrome: Recent advances and protocol for umbrella reviews of meta-analyses in major arrhythmic events risk stratification
Aziz, H., Zarzecki, Michał P, Garcia-Zamora, Sebastian, Kim, Min Seo, Bijak, Piotr, Tse, Gary, Won, Hong-Hee and Matusik, P. 2022. Pathogenesis and management of Brugada Syndrome: Recent advances and protocol for umbrella reviews of meta-analyses in major arrhythmic events risk stratification. Journal of Clinical Medicine. 11 (7), p. 1912. https://doi.org/jcm11071912
Comparisons of the risk of myopericarditis between COVID-19 patients and individuals receiving COVID-19 vaccines: a population-based study.
Chou, O., Zhou, Jiandong, Lee, Teddy Tai Loy, Kot, Thompson, Lee, Sharen, Wai, Abraham Ka Chung, Wong, Wing Tak, Zhang, Qingpeng, Cheng, Shuk Han, Liu, Tong, Vassiliou, Vassilios S, Cheung, Bernard Man Yung and Tse, Gary 2022. Comparisons of the risk of myopericarditis between COVID-19 patients and individuals receiving COVID-19 vaccines: a population-based study. Clinical research in cardiology : official journal of the German Cardiac Society. https://doi.org/10.1007/s00392-022-02007-0
Liver immune-related adverse effects of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors: A propensity score matched study with competing risk analyses
Zhou, J, Chau, Y-L A, Yoo, J W, Lee, S, Ng, K, Dee, E C, Liu, T, Wai, A K C, Zhang, Q and Tse, G 2022. Liver immune-related adverse effects of programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors: A propensity score matched study with competing risk analyses. Clinical Oncology (Royal College of Radiologists (Great Britain)). https://doi.org/10.1016/j.clon.2022.03.006
EPR22-112: Risk of prostate cancer for Metformin versus Sulphonylurea monotherapy in Type 2 Diabetes Mellitus: A propensity score-matched retrospective cohort study
Lee, Yan Hiu Athena, Zhou, Jiandong, Hui, Jeremy Man Ho, Liu, Xuejin, Lee, Teddy Tai Loy, Hui, Kyle, Wai, Abraham Ka Chung, Wong, Wing Tak, Liu, Tong, Ng, Kenrich, Lee, Sharen, Dee, Edward Christopher, Chan, Jeffrey Shi Kai, Zhang, Qingpeng and Tse, Gary 2022. EPR22-112: Risk of prostate cancer for Metformin versus Sulphonylurea monotherapy in Type 2 Diabetes Mellitus: A propensity score-matched retrospective cohort study. Journal of the National Comprehensive Cancer Network. 20 (3.5), pp. EPR22-112. https://doi.org/10.6004/jnccn.2021.7189
Predictive risk models for forecasting arrhythmic outcomes in Brugada syndrome: A focused review
Chung, Cheuk To, Bazoukis, George, Radford, Danny, Coakley-Youngs, Emma, Rajan, Rajesh, Matusik, Paweł T, Liu, Tong, Letsas, Konstantinos P, Lee, Sharen and Tse, Gary 2022. Predictive risk models for forecasting arrhythmic outcomes in Brugada syndrome: A focused review. Journal of Electrocardiology. 72, pp. 28-34. https://doi.org/10.1016/j.jelectrocard.2022.02.009
Right ventricular outflow tract endocardial unipolar substrate mapping: implications in risk stratification of Brugada syndrome
Letsas, Konstantinos P, Vlachos, Konstantinos, Efremidis, Michael, Dragasis, Stylianos, Korantzopoulos, Panagiotis, Tse, Gary, Liu, Tong, Bazoukis, George, Niarchou, Panagioula, Prappa, Efstathia, Sacher, Frederic, Hocini, Meleze and Baranchuk, Adrian 2022. Right ventricular outflow tract endocardial unipolar substrate mapping: implications in risk stratification of Brugada syndrome. Reviews in Cardiovascular Medicine. 23 (2), p. 44. https://doi.org/S1530-6550(22)00331-3
A novel three-dimensional and tissue Doppler echocardiographic index for diagnosing and prognosticating heart failure with preserved ejection fraction
Wang, Weiding, Mu, Guanyu, Liu, Changle, Xie, Juan, Zhang, Hao, Zhang, Xiaowei, Che, Jingjin, Tse, Gary, Liu, Tong, Li, Guangping and Fu, Huaying 2022. A novel three-dimensional and tissue Doppler echocardiographic index for diagnosing and prognosticating heart failure with preserved ejection fraction. Frontiers in Cardiovascular Medicine. 9, p. 822314. https://doi.org/10.3389/fcvm.2022.822314
Type 2 innate immunity drives distinct neonatal immune profile conducive for heart regeneration.
Chen, Francis M, Tse, Joyce Ky, Jin, Leigang, Chook, Chui Yiu Bamboo, Leung, Fung Ping, Tse, Gary, Woo, Connie W, Xu, Aimin, Chawla, Ajay, Tian, Xiao Yu, Chan, Ting-Fung and Wong, Wing Tak 2022. Type 2 innate immunity drives distinct neonatal immune profile conducive for heart regeneration. Theranostics. 12 (3), pp. 1161-1172. https://doi.org/10.7150/thno.67515
Effectiveness of sacubitril-valsartan in patients with cancer therapy-related cardiac dysfunction (CTRCD): a systematic review of clinical and preclinical studies
Duraes, Andre R, Bitar, Yasmin S, Neto, Mansueto G, Mesquita, Evandro T, Chan, Jeffrey S, Tse, Gary, Liu, Tong, Boochi, Edimar A, Biondi-Zoccai, Giuseppe and Roever, Leonardo 2022. Effectiveness of sacubitril-valsartan in patients with cancer therapy-related cardiac dysfunction (CTRCD): a systematic review of clinical and preclinical studies. Minerva Medica. https://doi.org/10.23736/S0026-4806.22.08029-6
Metformin versus sulphonylureas for new onset atrial fibrillation and stroke in type 2 diabetes mellitus: a population-based study.
Zhou, Jiandong, Zhang, Guoming, Chang, Carlin, Chou, O., Lee, Sharen, Leung, Keith Sai Kit, Wong, Wing Tak, Liu, Tong, Wai, Abraham Ka Chung, Cheng, Shuk Han, Zhang, Qingpeng and Tse, Gary 2022. Metformin versus sulphonylureas for new onset atrial fibrillation and stroke in type 2 diabetes mellitus: a population-based study. Acta Diabetologica. https://doi.org/10.1007/s00592-021-01841-4
The value of IGF-1 and IGFBP-1 in patients with heart failure with reduced, mid-range, and preserved ejection fraction
Guo, Shaohua, Gong, Mengqi, Tse, Gary, Li, Guangping, Chen, Kang-Yin and Liu, Tong 2022. The value of IGF-1 and IGFBP-1 in patients with heart failure with reduced, mid-range, and preserved ejection fraction. Frontiers in Cardiovascular Medicine. 8, p. 772105. https://doi.org/10.3389/fcvm.2021.772105
Cardiac abnormalities after induction of endoplasmic reticulum stress are associated with mitochondrial dysfunction and connexin43 expression
He, Jinli, Gong, Mengqi, Wang, Zaojia, Liu, Daiqi, Xie, Bingxin, Luo, C., Li, Guangping, Tse, Gary and Liu, T. 2021. Cardiac abnormalities after induction of endoplasmic reticulum stress are associated with mitochondrial dysfunction and connexin43 expression. Clinical and Experimental Pharmacology and Physiology. https://doi.org/10.1111/1440-1681.13541
Hip fractures risks in edoxaban versus warfarin users: A propensity score-matched population-based cohort study with competing risk analyses
Zhou, Jiandong, Lee, Sharen, Liu, Xuejin, Iltaf Satti, Danish, Tai Loy Lee, Teddy, Hou In Chou, Oscar, Chang, Carlin, Roever, Leonardo, Tak Wong, Wing, Ka Chung Wai, Abraham, Liu, Tong, Zhang, Qingpeng and Tse, Gary 2021. Hip fractures risks in edoxaban versus warfarin users: A propensity score-matched population-based cohort study with competing risk analyses. Bone. 156, p. 116303. https://doi.org/S8756-3282(21)00469-5
Fragmented QRS is independently predictive of long-term adverse clinical outcomes in Asian patients hospitalized for heart failure: A retrospective cohort study
Chan, Jeffrey Shi Kai, Zhou, Jiandong, Lee, Sharen, Li, Andrew, Tan, Martin, Leung, Keith Sai Kit, Jeevaratnam, Kamalan, Liu, Tong, Roever, Leonardo, Liu, Ying, Tse, Gary and Zhang, Qingpeng 2021. Fragmented QRS is independently predictive of long-term adverse clinical outcomes in Asian patients hospitalized for heart failure: A retrospective cohort study. Frontiers in Cardiovascular Medicine. 8, p. 738417. https://doi.org/10.3389/fcvm.2021.738417
Effect of angiotensin receptor neprilysin inhibitors on left atrial remodeling and prognosis in heart failure
Sun, Yuxi, Song, Shuang, Zhang, Yanli, Mo, Wenqiong, Zhang, Xinxin, Wang, Ning, Xia, Yunlong, Tse, Gary and Liu, Ying 2021. Effect of angiotensin receptor neprilysin inhibitors on left atrial remodeling and prognosis in heart failure. ESC Heart Failure. 9 (1), pp. 667-675. https://doi.org/10.1002/ehf2.13691
Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source
Ning, Yuye, Tse, G., Luo, Guogang and Li, Guoliang 2021. Atrial cardiomyopathy: An emerging cause of the embolic stroke of undetermined source. Frontiers in Cardiovascular Medicine. 8, p. 674612. https://doi.org/10.3389/fcvm.2021.674612
Ventricular tachyarrhythmia risk in paediatric/young vs. adult Brugada Syndrome patients: A territory-wide study
Lee, Sharen, Wong, Wing Tak, Wong, Ian Chi Kei, Mak, Chloe, Mok, Ngai Shing, Liu, Tong and Tse, Gary 2021. Ventricular tachyarrhythmia risk in paediatric/young vs. adult Brugada Syndrome patients: A territory-wide study. Frontiers in Cardiovascular Medicine. 8, p. 671666. https://doi.org/10.3389/fcvm.2021.671666
The association between blood pressure variability and hip or vertebral fracture risk: A population-based study
Zhou, Jiandong, Li, Helen, Chang, Carlin, Wu, William K.K., Wang, Xiansong, Liu, Tong, Cheung, Bernard Man Yung, Zhang, Qingpeng, Lee, Sharen and Tse, Gary 2021. The association between blood pressure variability and hip or vertebral fracture risk: A population-based study. Bone. 150, p. 1160115. https://doi.org/10.1016/j.bone.2021.116015