Abstract 14626: Heart Failure with Preserved and Reduced Ejection Fraction: One Disease Process or Two?
Background: Heart failure (HF) can occur in patients with reduced or preserved ejection fraction (EF), but it remains unclear whether these forms of HF represent discrete disease entities or are part of the same HF disease spectrum.
Methods: We examined the distribution of EF in two populations of HF patients. The hospital cohort included consecutive (referral and community) patients hospitalized with decompensated HF at Mayo Clinic Hospitals in Olmsted County, Minnesota from 1987–2002. The population-based community cohort included Olmsted County residents presenting with HF in either the inpatient or outpatient setting who were prospectively enrolled from 2003–2009.
Results: The hospital cohort included 4910 HF patients (44% women, mean age 73.0 years) while the community cohort included 1220 HF patients (49% women, mean age 75.1 years). In total, 47% (n=2284) of the hospital cohort and 56% (n=680) of the community cohort had preserved EF (≥50%). However, EF did not exhibit a Gaussian distribution, but rather followed a bimodal distribution in both the inpatient and community populations (Figure). Discussion: EF follows a bimodal distribution in patients with HF. These data support the notion that while HF with preserved and reduced EF share many of the same clinical manifestations, they are two distinct disease entities characterized by unique pathophysiology and requiring specific therapy.
- © 2010 by American Heart Association, Inc.