Heart Failure With Midrange Ejection Fraction: Prior Left Ventricular Ejection Fraction and Prognosis

Aims: 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 with midrange (HFmrEF) category when preserved (HFpEF) deteriorates or reduced (HFrEF) improves. In this study, we association between change in LVEF and adverse outcomes. Methods: HFmrEF patients at least two more echocardiograms 3 months apart First Affiliated Hospital Dalian Medical University September 1, 2015 November 30, 2019 were identified. According to LVEF, subjects divided into improved group (prior < 40%), stable 40 50%), deteriorated ? 50%). The primary outcomes cardiovascular death, all-cause mortality, hospitalization worsening failure, composite event mortality hospitalization. Results: A total 1,168 (67.04% male, mean age 63.60 ± 12.18 years) included. percentages improved, stable, 310 (26.54%), 334 (28.60%), 524 (44.86%), respectively. After a period follow-up, 208 (17.81%) died 500 met endpoint. rates 35 (11.29%), 55 (16.47%), 118 (22.52%), outcome was 102 (32.90%), 145 (43.41%), 253 (48.28%) groups, Cox regression analysis showed that deterioration had higher risk death (HR: 1.707, 95% CI: 1.064–2.739, P = 0.027), (HR 1.948, CI 1.335–2.840, 0.001), 1.379, 1.096–1.736, 0.006) compared improvement group. still remained significant after fully adjusted both 1.899, 1.247–2.893, 0.003) 1.324, 1.020–1.718, 0.035). Conclusion: are heterogeneous three different subsets identified, each Strategies managing should include previously measured allow stratification based direction changes better optimize treatment.