Abstract 12572
Stroke Volume and Cardiovascular Event Risk in Heart Failure With Preserved Ejection Fraction
- Ito, Shinya
- Kitai, Takeshi
- Yamane, Takafumi
- Kim, Kitae
- Ota, Mitsuhiko
- Sasaki, Yasuhiro
- Ehara, Natsuhiko
- Kobori, Atsushi
- Kinoshita, Makoto
- Kaji, Shuichiro
- Furukawa, Yutaka
Introduction: Heart failure with preserved ejection fraction (HFpEF) is a significant and increasing public health problem, which has similar outcomes to HF with reduced EF (HFrEF). However, the prognostic factors of HFpEF have not been clarified. Recently, it has been reported that stroke volume (SV) is often reduced in HFpEF patients regardless of preserved EF. This study aimed to determine the importance of SV assessment on clinical outcomes in patients with HFpEF.
Methods: We retrospectively reviewed 699 consecutive patients with acutely decompensated heart failure who were admitted in our institution between 2009 and 2011. Among them, both baseline and follow-up data including echocardiography were available in 425 patients. The patients were divided into 3 groups; EF≥50% (HFpEF), 41-49% (borderline), and EF<40%(HFrEF), and clinical outcomes were compared among the groups. SV was estimated noninvasively from LV volume obtained by transthoracic echocardiography.
Results: The mean follow-up period was 2.4±1.8 years. There were 176 patients (41%) with HFpEF, 70 (16%) with borderline and 182 (43%) with HFrEF. There were no significant differences among the 3 groups with respect to actuarial survival (67% vs 58% vs 68%, P=0.33), and event-free survival, defined as a composite of death from any cause, HF readmission, myocardial infarction and stroke (44% vs 33% vs 40%, P=0.20) at 3 years. In HFpEF patients, there were 48 patients (28%) with low SV (<35ml) who had significantly worse outcomes than those with preserved SV (≥35ml) regarding all-cause mortality and cardiovascular events (Figure).
Conclusions: Low SV regardless of preserved EF could be a possible marker for high risk patients with HFpEF.