Special prognostic phenomenon for patients with mid-range ejection fraction heart failure: a systematic review and meta-analysis
10.1097/CM9.0000000000000653
- Author:
Guo PAN
1
;
Dai JIAN-FENG
;
Feng CHAO
;
Chen SHU-TAO
;
Feng JIN-PING
Author Information
1. Department of Cardiology
- Keywords:
Heart failure;
Ejection fraction;
Mid-range;
Prognosis;
Meta-analysis
- From:
Chinese Medical Journal
2020;133(4):452-461
- CountryChina
- Language:Chinese
-
Abstract:
Background:Clinical features and outcomes of heart failure (HF) with mid-range ejection fraction (HFmrEF) remain controversial.Thus,we systematically reviewed literatures of clinical research to assess and analyze characteristics and prognosis of patients with HFmrEF.Methods:PubMed,Embase,and Web of Science were searched for cohort studies up to April 23,2019.Clinical features and multivariate adjusted hazard ratios (HRs) of endpoints of short-term all-cause mortality (SAM),long-term all-cause mortality (LAM),long-term cardiovascular death (LCD) and long-term HF rehospitalization (LHR) among patients with HFmrEF and HF with preserved ejection fraction (HFpEF),HF with reduced ejection fraction (HFrEF) were well addressed.The primary outcome was LAM.Results:Totally 19 studies were included in this study with 164,678 patients enrolled.The follow-up time of LAM was 3.6 ± 2.5 years.HRs of LAM,SAM,LCD,LHR indicated that the risks of patients with HFmrEF were higher than HFpEF patients but lower than HFrEF patients,as for LAM,HFmrEF:HFpEF (reference) HR:1.07,95％ confidence interval (CI):1.00-1.15 (I2=63％,P =0.0005);HFmrEF:HFrEF (reference) HR:0.80,95％ CI:0.73-0.88 (I2=70％,P ＜ 0.0001).However,HFmrEF patients had the lowest rate in LAM (30.94％),SAM (2.73％),LCD (17.45％),LHR (26.36％) compared with the other two groups.Conclusions:This systematic review and meta-analysis compared features and prognosis between patients with HFmrEF and HFpEF,HFrEF by HRs.There appeared a special "separation phenomenon" showing rates of endpoints were inconsistent with their hazards in patients with HFmrEF compared with HFpEF patients.
