Abstract：
The study investigates the characteristics and prognostic impact of different heart failure (HF) etiologies in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
Data regarding the characterization of patients with HFmrEF and their outcomes is scarce.
Consecutive patients with HFmrEF (i.e., left ventricular ejection fraction 41-49 % and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Patients with ischemic cardiomyopathy (ICM) were compared to patients without ischemic cardiomyopathy (non-ICM). The primary endpoint was all-cause mortality at 30 months (median follow-up). Statistical analyses included Kaplan-Meier, multivariable Cox proportional regression analyses and propensity score matching.
From a total of 1,832 patients hospitalized with HFmrEF, ICM was the most common HF etiology in 68.7 %, followed by hypertensive (9.7 %) and primary non-ischemic cardiomyopathies (NICM) (8.1 %). Within the entire study cohort, the presence of ICM was not associated with the risk of all-cause mortality (HR = 0.864; 95 % CI 0.723 - 1.031), however after multivariable adjustment (HR = 0.792; 95 % CI 0.646 - 0.972; p = 0.026) and propensity score matching (25.7% vs. 31.4 %; log rank p = 0.050), the presence of ICM was associated with lower risk of all-cause mortality at 30 months compared to patients without ICM.
ICM is the most common etiology of HF in HFmrEF and may be associated with favorable outcomes. This may be related to better adherence to pharmacological treatment and improved revascularization strategies for HFmrEF patients with ICM.
Data regarding the characterization of patients with HFmrEF and their outcomes is scarce.
Consecutive patients with HFmrEF (i.e., left ventricular ejection fraction 41-49 % and signs and/or symptoms of HF) were retrospectively included at one institution from 2016 to 2022. Patients with ischemic cardiomyopathy (ICM) were compared to patients without ischemic cardiomyopathy (non-ICM). The primary endpoint was all-cause mortality at 30 months (median follow-up). Statistical analyses included Kaplan-Meier, multivariable Cox proportional regression analyses and propensity score matching.
From a total of 1,832 patients hospitalized with HFmrEF, ICM was the most common HF etiology in 68.7 %, followed by hypertensive (9.7 %) and primary non-ischemic cardiomyopathies (NICM) (8.1 %). Within the entire study cohort, the presence of ICM was not associated with the risk of all-cause mortality (HR = 0.864; 95 % CI 0.723 - 1.031), however after multivariable adjustment (HR = 0.792; 95 % CI 0.646 - 0.972; p = 0.026) and propensity score matching (25.7% vs. 31.4 %; log rank p = 0.050), the presence of ICM was associated with lower risk of all-cause mortality at 30 months compared to patients without ICM.
ICM is the most common etiology of HF in HFmrEF and may be associated with favorable outcomes. This may be related to better adherence to pharmacological treatment and improved revascularization strategies for HFmrEF patients with ICM.
摘要：
目的：本研究调查了射血分数轻度降低的心力衰竭（HFmrEF）患者不同心力衰竭（HF）病因的特点和预后影响。
背景：关于HFmrEF患者的特征及其结局的数据很少。
方法：连续患有HFmrEF的患者（即，2016年至2022年，在一家机构回顾性纳入了左心室射血分数41-49%和HF的体征和/或症状）。将患有缺血性心肌病（ICM）的患者与没有缺血性心肌病（非ICM）的患者进行比较。主要终点是30个月时的全因死亡率（中位随访）。统计分析包括Kaplan-Meier，多变量Cox比例回归分析和倾向评分匹配。
结果：从总共1,832例HFmrEF住院患者中，ICM是最常见的HF病因，占68.7%，其次是高血压（9.7％）和原发性非缺血性心肌病（NICM）（8.1％）。在整个研究队列中，ICM的存在与全因死亡风险无关(HR=0.864;95%CI0.723-1.031),然而，经过多变量调整(HR=0.792；95%CI0.646-0.972；p=0.026)和倾向评分匹配(25.7%vs.31.4%；对数秩p=0.050)，与无ICM的患者相比,ICM的存在与30个月时全因死亡率风险较低相关.
结论：ICM是HFmrEF中最常见的HF病因，可能与良好的预后相关。这可能与更好地坚持药物治疗和改善ICMHFmrEF患者的血运重建策略有关。
背景：关于HFmrEF患者的特征及其结局的数据很少。
方法：连续患有HFmrEF的患者（即，2016年至2022年，在一家机构回顾性纳入了左心室射血分数41-49%和HF的体征和/或症状）。将患有缺血性心肌病（ICM）的患者与没有缺血性心肌病（非ICM）的患者进行比较。主要终点是30个月时的全因死亡率（中位随访）。统计分析包括Kaplan-Meier，多变量Cox比例回归分析和倾向评分匹配。
结果：从总共1,832例HFmrEF住院患者中，ICM是最常见的HF病因，占68.7%，其次是高血压（9.7％）和原发性非缺血性心肌病（NICM）（8.1％）。在整个研究队列中，ICM的存在与全因死亡风险无关(HR=0.864;95%CI0.723-1.031),然而，经过多变量调整(HR=0.792；95%CI0.646-0.972；p=0.026)和倾向评分匹配(25.7%vs.31.4%；对数秩p=0.050)，与无ICM的患者相比,ICM的存在与30个月时全因死亡率风险较低相关.
结论：ICM是HFmrEF中最常见的HF病因，可能与良好的预后相关。这可能与更好地坚持药物治疗和改善ICMHFmrEF患者的血运重建策略有关。
