The impact of left ventricular ejection fraction on heart failure patients with pulmonary hypertension.
Heart Lung
; 48(6): 502-506, 2019.
Article
em En
| MEDLINE
| ID: mdl-31174892
ABSTRACT
BACKGROUND:
The most common cause of pulmonary hypertension (PH) in developed countries is left heart disease (LHD, group 2 PH). The development of PH in heart failure (HF) patients is indicative of worse outcomes.OBJECTIVE:
The aim of this study was to evaluate the long term outcomes of HF patients with PH in a national long-term registry.METHODS:
Study included 9 cardiology centers across Israel between 01/2013-01/2015, with a 12-month clinical follow-up and 24-month mortality follow-up. Patients were age ≥18 years old with HF and pre-inclusion PH due to left heart disease determined by echocardiography [estimated systolic pulmonary arterial pressure (SPAP) ≥ 50â¯mmHg]. Patients were categorized into 3 groups HF with reduced (HFrEF < 40%), mid-range (HFmrEF 40-49%), and preserved (HFpEF ≥ 50%) ejection fraction.RESULTS:
The registry included 372 patients, with high prevalence of cardiovascular risk factors. Median HF duration was 4 years and 65% were in severe HF New York Heart Association (NYHA) classification ≥3. Mean systolic pulmonary artery pressure (SPAP) was 62 ± 11â¯mmHg. During 2-years of follow-up, 54 patients (15%) died. Univariable predictors of mortality included NYHA grade 3-4, chronic renal failure, and SPAP ≥ 65â¯mmHg. Severe PH was associated with mortality in HFpEF, but not HFmrEF or HFrEF, and remained significant after multivariable adjustment with an adjusted hazard ratio of 2.99, (95%CI 1.29-6.91, pâ¯=â¯0.010).CONCLUSIONS:
The combination of HFpEF with severe PH was independently associated with increased mortality. Currently, HFpEF patients are included with group 2 PH patients. Defining HFpEF with severe PH as a sub-class may be more appropriate, as these patients are at increased risk and deserve special consideration.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Volume Sistólico
/
Função Ventricular Esquerda
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Insuficiência Cardíaca
/
Hipertensão Pulmonar
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Heart Lung
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Israel