Abstract 9729: Should HF Preserved-Ejection Fraction Patients Participate in a HF Program?
Introduction: Optimal treatment regimens for individuals with Heart Failure preserved Ejection Fraction (HFpEF) have yet to be defined and these patients comprise nearly half the heart failure (HF) population. We present outcomes of this patient population from our first year in a heart failure program (HFP).
Hypothesis: HFpEF patients will benefit as much as heart failure reduced ejection fraction (HFrEF) patients from a HFP.
Methods: Retrospective review of 142 HFP patients (HFpEF n=56, HFrEF n=86). Baseline, 3 and 6 month assessments of NYHA class, six minute walk, and Minnesota Living with Heart Failure Questionnaire (MLWHF) were completed. Three month hospital admissions before and after HFP enrollment were reviewed.
The HFP provides an inpatient consult service for acutely decompensated HF patients and weekly interdisciplinary rounds. Transition of care with telemonitoring for 30 days post discharge assessing med reconciliation, weight, BP, signs of worsening HF and treatment as needed . The outpatient HF Clinic optimizes guideline directed medical therapy (GDMT), provides self-care education with HFSA modules, exercise prescriptions, dietician consults, and intravenous diuretics if needed.
Results: HFpEF comprised 39% of all patients in the HFP. HFpEF group had more females-(HFpEF-52%, HFrEF-35%). HFrEF patients had more CAD. No differences in the comorbidities of AF, HTN, DM, CKD, COPD, anemia or NA level were seen. Similar GDMT utilization was observed in both groups. HFrEF and HFpEF improved NYHA Class, 6MW, and QOL over the first six months. Compared to 3 months before HFP enrollment, all-cause admissions 3 months after HFP were reduced by 81% in the HFpEF vs 60% in the HFrEF group (p=0.0236).
Conclusions: Both HFpEF and HFrEF benefit from enrollment in a HFP. HFpEF saw a greater reduction in all-cause three month readmissions after enrolling in the HFP. The QOL and functional improvements reach significance in both groups at six months.
Author Disclosures: L. Kelly: None. G. Steahr: None. B. Hott: None.
- © 2014 by American Heart Association, Inc.