Predictive value of heart failure with reduced versus preserved ejection fraction for outcome in pulmonary embolism

ESC Heart Failure

Stavros Konstantinides¹  Natasa Markovic‐Nikolic²  Boris Dzudovic³  Zorica Mladenovic³  Bojana Subotic³  Slobodan Obradovic³  Ljiljana Kos⁴  Tamara Kovacevic‐Preradovic⁴  Maja Nikolic⁵  Vladimir Miloradovic⁵  Sonja Salinger‐Martinovic⁶  Nenad Zec⁷  Ana Kovacevic‐Kuzmanovic⁷  Aleksandar Neskovic⁸  Ilija Srdanovic⁹  Sandra Pekovic^1,10  Aleksandar Bokan^1,10  Jovan Matijasevic^1,10  Jadranka Trobok^1,10  Ljiljana Jovanovic^1,11  Zoran Gluvic^1,12  Sasa Pancevacki^1,12  Srdjan Kafedzic^1,12 

[1] Center for Thrombosis and Hemostasis Johannes Gutenberg University of Mainz Mainz Germany;Clinic of Cardiology University Hospital Zvezdara Belgrade Serbia;Clinic of Cardiology and Emergency Internal Medicine Military Medical Academy Belgrade Serbia;Clinic of Cardiology, Clinical Center Banja Luka, School of Medicine University of Banja Luka Banja Luka Republic of Srpska, Bosnia and Herzegovina;Clinic of Cardiology, Clinical Center Kragujevac, School of Medicine University of Kragujevac Kragujevac Serbia;Clinic of Cardiology, Clinical Center Nis University of Niš Niš Serbia;Department for Internal Medicine General Hospital Pancevo Pancevo Serbia;Faculty of Medicine University of Belgrade Belgrade Serbia;Institute for Cardiovascular Medicine Vojvodina, School of Medicine University of Novi Sad Novi Sad Serbia;Institute for Pulmonary Diseases of Vojvodina Sremska Kamenica Serbia;Institute of Medical Biochemistry Military Medical Academy Belgrade Serbia;Intensive Care Unit, Clinic of Internal Medicine Clinical Hospital Center Zemun Belgrade Serbia;

关键词: Pulmonary embolism;    Mortality;    Heart failure;    Ejection fraction;   

DOI  :  10.1002/ehf2.13015

来源: DOAJ

【 摘 要 】

Abstract Aims This study aimed to investigate whether the risk of short‐term mortality is different in pulmonary embolism (PE) patients who have heart failure with reduced ejection fraction (HFrEF) as compared with those with heart failure with preserved ejection fraction (HFpEF). Methods and results Predictive value of HFrEF or HFpEF for 7‐day (intrahospital) and 30‐day all‐cause mortality was determined in the cohort of 1055 out of 1201 consecutive acute PE patients from the Serbian multicentre PE registry. Patients were classified into either HFrEF or HFpEF group, according to guideline‐proposed criteria. A 7‐day (intrahospital) and 30‐day all‐cause mortality was 18.5% vs. 7.3% vs. 4.5% (P < 0.001) and 22.2% vs. 16.3% vs. 7.9% (P < 0.001) for patients with the history of HFrEF, HFpEF, and without HF, respectively. Multivariable analysis adjusted to age, gender, history of chronic obstructive pulmonary disease, diabetes mellitus, arterial hypertension, presence of atrial fibrillation, and mortality risk assessment at admission has shown that only HFrEF, but not HFpEF, was an independent predictor for 7‐day mortality (hazard ratio 2.22, 95% confidence interval 1.25‐4,38.41, P = 0.021) and neither HFrEF or HFpEF was an independent predictor for 30‐day mortality. Among various admission parameters associated to PE outcome, only systolic pressure in HFrEF patients (P < 0.001), heart rate (P = 0.01), and right ventricle systolic pressure (P = 0.039) in HFpEF patients were significantly different in patients who died compared with those who survived at 7 days. Conclusions Our study has shown that the presence of previous history of HFrEF, but not HFpEF, in acute PE is an independent risk factor for mortality at 7 days.

【 授权许可】

Unknown