Abstract 12673: Mode of Death in Patients with Heart Failure and Preserved Ejection Fraction
Background: Patients with heart failure and preserved ejection fraction (HFPEF) had high mortality. However, there were limited studies about the mode of death in HFPEF patients, especially in Chinese population.
Methods: We studied 1462 consecutive heart failure (HF) patients admitted to our hospital from 2006-2010 with HF symptoms. Left ventricular ejection fraction (LVEF) was evaluated by echocardiography during hospitalization. Specific cause of death within 1 year’s follow-up was compared between HFPEF (EF≥50%) and HF patients with reduced ejection fraction (HFREF; EF≤50%).
Results: 611 patients were HFREF and 851 were HFPEF in our cohort. 1-year all cause mortality rates were 29.5% (181 patients) in HFREF and 21.0% (171 patients) in HFPEF (P≤0.001). The mode of death in HFPEF was cardiovascular (CV) in 57.3% [including 20.5% refractory HF, 13.5% sudden death, 9.4% acute coronary syndrome (ACS), 5.8% stroke and 1.2% other CV reasons], non-CV in 30.1%, and unknown in 12.3% (Figure). The prevalence of CV death was higher in patients with HFREF compared to HFPEF (69.3% vs.57.3%, P=0.02). Refractory HF, the most common mode of death, was similar between HFREF and HFPEF (18.8% vs. 20.5%, P=0.69). In contrast, non-CV mortality was significantly higher in HFPEF than those with HFREF (30.1% vs. 22.4%, P=0.02). Multivariate Cox-regression analysis found age [Hazard Ratios (HR) 1.04, 95% Confidential Interval (CI) 1.01-1.06, p=0.005], serum albumin level (HR 0.90, 95% CI 0.87-0.94, p≤0.001) and systolic blood pressure on admission (HR 0.99, 95% CI 0.97-0.99, p=0.03) were independent predictors of 1 year CV death in HFPEF patients.
Conclusions: The majority of deaths in HFPEF were cardiovascular. Among cardiovascular deaths, refractory heart failure death was the leading modes of death in HFPEF. Compared with HFREF, the proportions of non-cardiovascular deaths were higher in HFPEF.
- © 2013 by American Heart Association, Inc.