Internal Medicine Service, Hospital General de la Defensa, Zaragoza, Spain.
Research Group on Heart Failure, IIS Aragón, Zaragoza, Spain.
Acta Cardiol. 2023 Apr;78(2):233-240. doi: 10.1080/00015385.2022.2059135. Epub 2022 Aug 10.
We aimed to characterise and compare the clinical profile of heart failure (HF) with mid-range (HFmrEF), reduced (HFrEF) and preserved (HFpEF) left-ventricular ejection fraction.
We conducted a descriptive, observational study in 267 HF patients admitted to the Internal Medicine department of a tertiary hospital during 2010-2016. The study population was divided into three groups according to the ejection fraction rate: HFrEF (<40%), HFmrEF (40-49%), and HFpEF (≥50%). We analysed and compared their demographic, clinical, and analytical characteristics.
The mean age of the study population was 79.5 (standard deviation, 8.14) years; 56.6% were males. The most common phenotype was HFpEF (58.1%), followed by HFrEF (21.7%) and HFmrEF (20.2%). Ischaemic cardiopathy was the primary aetiology in the HFmrEF and HFrEF groups, and arterial hypertension in the HFpEF group. The most common comorbidities among HFmrEF patients were diabetes (43.4%), chronic obstructive pulmonary disease (35.8%), and anaemia (35.8%); 49.1% had impairment of segmental myocardial contractility, and 35.8% ventricular dilatation. No differences in HF outcomes were observed among the three phenotypes.
HFmrEF shows characteristics similar to both HFpEF and HFrEF. Further large-scale studies with longer follow-up are needed to ascertain if it is worth distinguishing this phenotype in clinical practice in terms of management and prognosis.
本研究旨在描述和比较左心室射血分数中间值（HFmrEF）、低值（HFrEF）和高值（HFpEF）心力衰竭（HF）的临床特征。
我们进行了一项描述性、观察性研究，纳入了 2010 年至 2016 年期间在一家三级医院内科住院的 267 例 HF 患者。根据射血分数将患者分为三组：HFrEF（<40%）、HFmrEF（40-49%）和 HFpEF（≥50%）。我们分析并比较了三组的人口统计学、临床和分析特征。
研究人群的平均年龄为 79.5（标准差 8.14）岁，56.6%为男性。最常见的表型是 HFpEF（58.1%），其次是 HFrEF（21.7%）和 HFmrEF（20.2%）。HFmrEF 和 HFrEF 组的主要病因是缺血性心脏病，HFpEF 组则是动脉高血压。HFmrEF 患者最常见的合并症是糖尿病（43.4%）、慢性阻塞性肺疾病（35.8%）和贫血（35.8%）；49.1%的患者存在节段性心肌收缩功能障碍，35.8%的患者存在心室扩张。三种表型之间的 HF 结局无差异。
HFmrEF 表现出与 HFpEF 和 HFrEF 相似的特征。需要进一步进行大规模、长期随访的研究，以确定在管理和预后方面，该表型是否值得在临床实践中加以区分。
