Comparison of clinical characteristics and in-hospital outcomes of chronic heart failure patients with different left ventricular ejection fractions

Objective To compare the clinical characteristics and in-hospital outcomes of chronic heart failure (CHF) patients with different left ventricular ejection fractions (LVEF). Method 2 274 hospitalized CHF patients were enrolled from 9 hospitals in Beijing and retrospectively studied.All patients were classified into reduced (HFrEF: LVEF<40%), mid-range (HFmrEF: 40%≤LVEF≤49%) and preserved (HFpEF: LVEF≥50%) ejection fraction groups, according to LVEF.Characteristics, disease history, main cause for CHF, results of laboratory and echocardiographic examination, in-hospital treatment, prolonged hospitalization and in-hospital death were compared. Results 626 (27.5%) HFrEF patients, 466 (20.5%) HFmrEF patients and 1 182 (52.0%) HFpEF patients were enrolled.Mean systolic blood pressure (SBP), prevalence of previous hypertension, peripheral arterial disease and COPD were similar between HFmrEF and HFpEF groups, which were higher than their counterparts in HFrEF group.Coronary heart disease was the first cause of CHF in all groups.27.0% HFrEF patients had prolonged hospitalization, which was higher than HFmrEF (21.3%, P<0.017) and HFpEF (18.0%, P<0.017) groups.In-hospital mortality were 2.1%, 0.6% and 1.4% among HFrEF, HFmrEF and HFpEF patients, separately.However, differences were not found statistically significant.In multivariable logistic analysis, kidney dysfunction was positively associated with prolonged hospitalization in all groups (P<0.05); SBP≥120 mmHg(1 mmHg=0.133 kPa) was negatively related to in-hospital mortality among HFrEF patients(OR=0.20, 95%CI 0.05-0.78, P=0.021); older age was risk factor of in-hospital mortality for HFmrEF patients(OR=1.30, 95%CI 1.02-1.65, P=0.032); while heart rate was positively associated with in-hospital mortality among HFpEF patients (OR=1.04, 95%CI 1.01-1.06, P=0.001). Conclusion Poor in-hospital outcomes were observed in HFrEF, HFmrEF and HFpEF patients.However, within these groups, characteristics, disease history, main cause, examination results were not the same. More evidence was still needed to improve treatment of CHF patients with different LVEF. Key words: Left ventricular ejection fraction; Heart failure; Mortality; Influencers