Abstract 12269: Prognostic Role of Hemoconcentration in Acute Decompensated Heart Failure With Preserved and Reduced Ejection Fraction; an Analysis From Mode of Death
Backgrounds: Hemoconcentration (HC) during heart failure treatment is known to be associated with improved clinical outcome in patients with acute decompensated heart failure (ADHF). There is a difference in mode of death (cardiac [sudden vs pump failure death] vs non-cardiac death) between heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF). However, there is no information available on the different impact of HC in the prediction of mode of death in ADHF patients, relating to HFpEF and HFrEF.
Methods and Results: We studied 302 patients admitted with ADHF and discharged with survival (HFpEF(LVEF≥50%);n=139, HFrEF(LVEF<50%); n=163). HC was defined as an increase in hemoglobin level from admission to discharge. During a follow-up period of 5.1±4.3 yrs, 65 patients had cardiac death (sudden cardiac death in 37 and pump failure death in 27 patients) and 56 patients had non-cardiac death. HC was significantly associated with cardiac death in patients with HFrEF (p=0.02) but not in those with HFpEF, while there were no associations between HC and non-cardiac death in both patients with HFpEF and HFrEF. In patients with HFrEF, although there was no association between HC and sudden cardiac death, HC was significantly associated with pump failure death (adjusted HR 0.31 [95%CI 0.10-0.91], p=0.04), independently of relevant covariates such as systolic blood pressure and BUN. On the other hand, there was no association between HC and sudden or pump failure death in patients with HFpEF.
Conclusion: HC was related to improve pump failure death but not sudden cardiac death in hospitalized ADHF patients with HFrEF, not in those with HFpEF. This finding about clinical implication of HC might provide a new insight to decongestive therapy of ADHF in terms of LVEF.
Author Disclosures: T. Yamada: None. T. Morita: None. Y. Furukawa: None. S. Tamaki: None. Y. Iwasaki: None. M. Kawasaki: None. A. Kikuchi: None. T. Kondo: None. H. Hakui: None. M. Ishimi: None. T. Ozaki: None. Y. Satoh: None. I. Ikeda: None. E. Fukuhara: None. M. Fukunami: None.
- © 2015 by American Heart Association, Inc.