Left Ventricular Ejection Fraction (EF) of 55% as Cutoff for Late Transition From Heart Failure (HF) With Preserved EF to HF With Mildly Reduced EF

• Ueda Tomoya

  First Department of Internal Medicine, Nara Medical University

• Kawakami Rika

  First Department of Internal Medicine, Nara Medical University

• Nishida Taku

  First Department of Internal Medicine, Nara Medical University

• Onoue Kenji

  First Department of Internal Medicine, Nara Medical University

• Soeda Tsunenari

  First Department of Internal Medicine, Nara Medical University

• Okayama Satoshi

  First Department of Internal Medicine, Nara Medical University

• Takeda Yukiji

  First Department of Internal Medicine, Nara Medical University

• Watanabe Makoto

  First Department of Internal Medicine, Nara Medical University

• Kawata Hiroyuki

  First Department of Internal Medicine, Nara Medical University

• Uemura Shiro

  First Department of Internal Medicine, Nara Medical University

• Saito Yoshihiko

  First Department of Internal Medicine, Nara Medical University Department of Regulatory Medicine for Blood Pressure, Nara Medical University

抄録

Background:Heart failure (HF) with preserved (HFpEF) left ventricular ejection fraction (LVEF) is a syndrome with complex pathophysiology. Little is known about changes in LVEF that occur over time in HFpEF patients. A fundamental clinical question about HFpEF is whether HFpEF is an early manifestation of HF with reduced LVEF (HFrEF). If so, which patients with HFpEF are likely to show a decline in LVEF to less than 50%? The aim of the present study was to examine longitudinal changes in LVEF in patients with HFpEF.Methods and Results:Among 279 consecutive HFpEF patients admitted as emergencies, we examined 100 who underwent echocardiography at least 1 year after discharge. EF >50% was used as the definition of HFpEF. During a mean duration from hospitalization to follow-up echocardiography of 31.5 months, 11% of patients had LVEF ≤50% (mildly reduced LVEF), known as mildly reduced (HFmrEF). The utility of LVEF during hospitalization to predict HFmrEF was assessed with receiver-operating characteristic curve analysis. A cutoff value of 55% had sensitivity of 90.9% and specificity of 97.7%. Logistic regression analysis indicated that LVEF ≤55% and ischemic etiology were strong predictors of progression from HFpEF to HFmrEF (odds ratio [OR] 435, 95% confidence interval [CI] 52.65–10,614, P<0.0001 and OR 10.9, 95% CI 2.60–74.80, P=0.0007, respectively).Conclusions:The present study suggests that HFpEF patients with LVEF ≤55% may progress to HFmrEF in the future. (Circ J 2015; 79: 2209–2215)

収録刊行物

• Circulation Journal

  Circulation Journal 79 (10), 2209-2215, 2015

  一般社団法人 日本循環器学会

キーワード

• Cutoff value
• Echocardiography
• Heart failure
• Left ventricular ejection fraction

詳細情報

• CRID: 1390282680083723648
• NII論文ID: 130005099863
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-15-0425
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 026750039
• PubMed: 26227392
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026750039
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/10/79_CJ-15-0425/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2016200712
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
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