Intensive Care Unit, Beijing Longfu Hospital, Beijing - China.
Heart Center and Beijing Key Laboratory of Hypertension Research, Beijing Chaoyang Hospital, Capital Medical University, Beijing - China.
Arq Bras Cardiol. 2021 Oct;117(4):639-647. doi: 10.36660/abc.20200250.
Ejection fraction (EF) has been used in phenotype analyses and to make treatment decisions regarding heart failure (HF). Thus, EF has become a fundamental part of daily clinical practice.
This study aims to investigate the characteristics, predictors, and outcomes associated with EF changes in patients with different types of severe HF.
A total of 626 severe HF patients with New York Heart Association (NYHA) class III-IV were enrolled in this study. The patients were classified into three groups according to EF changes, namely, increased EF (EF-I), defined as an EF increase ≥10%, decreased EF (EF-D), defined as an EF decrease ≥10%, and stable EF (EF-S), defined as an EF change <10%. A p-value lower than 0.05 was considered significant.
Out of 377 severe HF patients, 23.3% presented EF-I, 59.5% presented EF-S, and 17.2% presented EF-D. The results further showed 68.2% of heart failure with reduced ejection fraction (HFrEF) in the EF-I group and 64.6% of heart failure with preserved ejection fraction (HFpEF) in the EF-D group. The predictors of EF-I included younger age, absence of diabetes, and lower left ventricular ejection fraction (LVEF). The predictors of EF-D were absence of atrial fibrillation, lower uric acid level, and higher LVEF. Within a median follow-up of 40 months, 44.8% of patients suffered from all-cause death.
In severe HF, HFrEF presented the highest percentage in the EF-I group, and HFpEF was most common in the EF-D group.
射血分数（EF）已被用于表型分析和心力衰竭（HF）的治疗决策。因此，EF 已成为日常临床实践的基本组成部分。
本研究旨在探讨不同类型严重 HF 患者 EF 变化的特征、预测因素和结局。
共纳入 626 例 NYHA 分级 III-IV 级的严重 HF 患者。根据 EF 变化将患者分为三组，即射血分数增加（EF-I）组，EF 增加≥10%；射血分数降低（EF-D）组，EF 降低≥10%；射血分数稳定（EF-S）组，EF 变化<10%。P 值<0.05 为差异有统计学意义。
在 377 例严重 HF 患者中，23.3%的患者 EF-I，59.5%的患者 EF-S，17.2%的患者 EF-D。结果还显示 EF-I 组中 68.2%为射血分数降低的心衰（HFrEF），EF-D 组中 64.6%为射血分数保留的心衰（HFpEF）。EF-I 的预测因素包括年龄较小、无糖尿病和较低的左心室射血分数（LVEF）。EF-D 的预测因素包括无房颤、较低的尿酸水平和较高的 LVEF。中位随访 40 个月期间，44.8%的患者发生全因死亡。
在严重 HF 中，EF-I 组中 HFrEF 占比最高，EF-D 组中 HFpEF 最常见。
