Salvador-Casabón JM, Grados-Saso D, Lacambra-Blasco I, Giménez-López I, Pérez-Calvo JI. Prognostic value of early reassessment of reduced ejection fraction in acute heart failure.
Rev Clin Esp 2023;
223:90-95. [PMID:
36564003 DOI:
10.1016/j.rceng.2022.10.006]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND OBJECTIVES
An improvement in left ventricular ejection fraction (LVEF) in patients with heart failure (HF) is associated with a better prognosis. Identifying these subjects early after an episode of decompensation, the necessary threshold of LVEF improvement, and its predictive factors are of great interest.
PATIENTS AND METHODS
One hundred and ten patients hospitalized for HF were prospectively reassessed at an early outpatient visit (mean of 38 days).
RESULTS AND CONCLUSIONS
In subjects with depressed LVEF (<50%), 50.7% presented an improvement in LVEF≥5% between the acute episode and the outpatient visit. This improvement in depressed LVEF was found to be useful for identifying patients with a good prognosis (readmission due to HF+cardiovascular mortality, p=0.022) but not in patients with preserved LVEF (≥50%). Patients with improved LVEF were significantly younger and had new-onset HF, a better global longitudinal strain (GLS), and better renal function. A multivariate logistic regression model found GLS, new-onset HF, and a lower LV mass index as predictors of LVEF improvement ≥5% (AUC 0.85).
Collapse