HFSA ePoster Library

Background: Heart failure with reduced ejection fraction (HFrEF) of < 40% is a well-studied class of CHF. Nevertheless, in patients with HFrEF and stable ejection fraction (EF) of 1 year, the effect of EF reduction degree on clinical outcomes is unclear. Methods: We screened 7668 echo studies to identify patients with stable HFrEF. Follow up was for 61.6 ± 31.0 months. Student’s t-test and chi-square test were used to assess baseline differences between MR-HFrEF group (with moderately reduced EF of 25-39%) and SR-HFrEF group (with severely reduced EF of < 25%). Kaplan Meier analysis was conducted to assess the association with all-cause mortality, cardiac mortality, and HF hospitalizations. Multivariate Cox regression was adjusted for significantly different baseline characteristics.
Results: A total of 207 patients were included. SR-HFrEF group (n = 110) had higher cardiac mortality and HF hospitalizations compared to MR-HFrEF group (n=97) with log-rank P = 0.039 and P = 0.0001 respectively. There was no difference in all-cause mortality. After adjustment for differences in age, gender, HTN, aldosterone antagonists, loop diuretics, thiazide diuretics, and digoxin along with DLP, DM, CAD, and CKD, the difference in cardiac mortality became insignificant but SR-HFrEF group continued to have higher HF hospitalizations with HR = 2.06 (95% CI = 1.38 - 3.05), P = 0.0001 figure 1.
Conclusion: We found that patients with stable SR-HFrEF had higher HF hospitalization rate compared to patients with stable MR-HFrEF.