Heart failure with preserved and reduced ejection fraction: different phenotypes in old-elderly patients?

Abstract:

BACKGROUND:Patients with heart failure with preserved ejection fraction (HFPEF) represent an important group of patients presenting in clinical practice. However, whether it is an earlier stage of heart failure with reduced ejection fraction (HFREF) remains uncertain. We evaluated the potential progression of HFPEF to HFREF. METHODS AND RESULTS:We evaluated retrospectively 178 patients (mean age 80.5±5.8 years; 75.3% females) with heart failure with preserved ejection fraction from a specialized Internal Medicine unit, offering an integrated usual care. Diagnosis of heart failure with preserved ejection fraction was made according to European guidelines. The main objective was to evaluate the progression to systolic dysfunction, defined by left ventricular ejection fraction less than 45%. Mean baseline left ventricular ejection fraction was 64.6±7.2. After a mean follow-up of 24-months, mean baseline ejection fraction was 67.1±9.3%. Only five patients (2.8%) progressed to HFREF. Brain natriuretic peptide values were significantly higher in those patients who progressed. CONCLUSIONS:These results strongly suggest that heart failure with preserved and reduced ejection fraction could be distinct pathophysiological entities, at least in elderly patients.

journal_name

Eur J Intern Med

authors

Páez-Rubio MI,Carrasco-Sánchez FJ,Escobar-Cervantes C,Sánchez-Gómez N,Santiago-Ruiz JL,Yebra-Yebra M,Manzano L

doi

10.1016/j.ejim.2013.01.018

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

346-8

issue

4

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(13)00038-1

journal_volume

24

pub_type

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