Abstract 12934: Prognostic Impact of Impaired Pulmonary Function in Acute Decompensated Heart Failure With Preserved Ejection Fraction
Background: An association between heart failure (HF) and impaired pulmonary function is clinically important. Therefore, we aimed to investigate the prognostic importance of impaired pulmonary function in acute decompensated heart failure (ADHF) patients.
Method: This study was prospective prognostic study performed as part of NARA-HF3 study between April 2011 and December 2014. ADHF patients were tested for pulmonary function using spirometry before discharge. The following pulmonary function test (PFT) was measured; forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Patients were classified into 2 groups based on predicted FVC and FEV1/FVC percent predicted ratio: normal PFT groups (FVC≥80%, FEV1/FVC≥70%) and abnormal PFT groups (obstructive, restrictive and mixed pattern).
Result: Among a total of 313 patients, 64.2% had abnormal spirometry (11.8%, 38.3% and 14.1% for obstructive, restrictive and mixed, respectively). Abnormal PFT groups were significantly older, had a higher prevalence of atrial fibrillation and a significantly higher mean LVEF compared to normal PFT groups. There was no significant difference in smoking history, sex, eGFR and BNP levels at discharge both groups. Abnormal PFT was found to be associated with higher rate of all-cause mortality or HF hospitalizations (Figure A, B). The abnormal PFT groups had worse prognosis than normal PFT groups in HF with preserved ejection fraction (HFpEF) (LVEF≥50%) but not in HF with reduced EF (HFrEF) (LVEF<50%) (Figure C, D). Cox proportional hazards regression analysis revealed that impaired pulmonary function was an independent prognostic predictor for ADHF, especially for HFpEF (HR 2.58, 95% CI 1.29 to 5.77, p=0.006).
Conclusion: Impaired pulmonary function was associated with poor prognosis in patients with HFpEF, but not in those with HFrEF.
Author Disclosures: R. Kawakami: None. Y. Nakada: None. T. Ueda: None. H. Okura: None. Y. Saito: Research Grant; Modest; Grants-in-Aid for Scientific Research (B), Challenging Exploratory Research (FY 2015), Health, Labour and Welfare Scientific Research. Research Grant; Significant; S, S, S. Other Research Support; Modest; MSD K.K. a subsidiary of Merck & Co., Inc., Daiichi Sankyo Co., Ltd., Bayer Holding Ltd., Baxter Ltd., Otsuka Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Astellas Pharma Inc., Takeda Pharmaceutical Co., Ltd., Ono Pharmatical Co., Ltd., Teijin Pharma Ltd., Mitsubishi Tanabe Pharma Corporation, Eisai Co., Ltd., ZERIA Pharmaceutical Co., Ltd., Nihon Medi-Physics Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Genzyme Japan K.K., Medtronic, Inc., Pfizer Japan Inc.. Other Research Support; Significant; S, S, S, S, S, S, S, S, S, S, S, S, S, S, M, M, M, M, M. Honoraria; Modest; Otsuka Pharmaceutical Co., Ltd, Takeda Pharmaceutical Co., Ltd, Mitsubishi Tanabe Pharma Corporation, Daiichi Sankyo Co., Ltd, MSD K.K. a subsidiary of Merck & Co., Inc, Novartis Pharma K.K., Bayer Holding Ltd, Kyowa Hakko Kirin Co., Ltd, Astellas Pharma Inc, Ono Pharmatical Co., Ltd, Pfizer Japan Inc.. Honoraria; Significant; M, M, M, M, M, M, M, M, M, M, M. Consultant/Advisory Board; Modest; Novartis Pharma K.K., Ono Pharmatical Co., Ltd, Pfizer Japan Inc.. Consultant/Advisory Board; Significant; M, M, M.
- © 2016 by American Heart Association, Inc.