Outcome of heart failure with preserved ejection fraction in a population-based study

R. Sacha Bhatia, Jack V. Tu, Douglas S. Lee, Peter C. Austin, Jiming Fang, Annick Haouzi, Yanyan Gong, Peter P. Liu

Research output: Contribution to journalArticle

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Abstract

Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent (heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent (heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure. Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days (5 percent vs. 7 percent, P = 0.08) and at 1 year (22 percent vs. 26 percent, P = 0.07); the adjusted one-year mortality rates were also not significantly different in the two groups (hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P = 0.18). The rates of readmission for heart failure and of in-hospital complications did not differ between the two groups. Conclusions: Among patients presenting with new-onset heart failure, a substantial proportion had an ejection fraction of more than 50 percent. The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction.

Original languageEnglish (US)
Pages (from-to)260-269
Number of pages10
JournalNew England Journal of Medicine
Volume355
Issue number3
DOIs
StatePublished - Jul 20 2006

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Heart Failure
Population
Patient Readmission
Mortality
Ontario
Atrial Fibrillation
Canada
History
Outcome Assessment (Health Care)
Confidence Intervals
Hypertension
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Bhatia, R. Sacha ; Tu, Jack V. ; Lee, Douglas S. ; Austin, Peter C. ; Fang, Jiming ; Haouzi, Annick ; Gong, Yanyan ; Liu, Peter P. / Outcome of heart failure with preserved ejection fraction in a population-based study. In: New England Journal of Medicine. 2006 ; Vol. 355, No. 3. pp. 260-269.
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abstract = "Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent (heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent (heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure. Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days (5 percent vs. 7 percent, P = 0.08) and at 1 year (22 percent vs. 26 percent, P = 0.07); the adjusted one-year mortality rates were also not significantly different in the two groups (hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P = 0.18). The rates of readmission for heart failure and of in-hospital complications did not differ between the two groups. Conclusions: Among patients presenting with new-onset heart failure, a substantial proportion had an ejection fraction of more than 50 percent. The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction.",
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Bhatia, RS, Tu, JV, Lee, DS, Austin, PC, Fang, J, Haouzi, A, Gong, Y & Liu, PP 2006, 'Outcome of heart failure with preserved ejection fraction in a population-based study', New England Journal of Medicine, vol. 355, no. 3, pp. 260-269. https://doi.org/10.1056/NEJMoa051530

Outcome of heart failure with preserved ejection fraction in a population-based study. / Bhatia, R. Sacha; Tu, Jack V.; Lee, Douglas S.; Austin, Peter C.; Fang, Jiming; Haouzi, Annick; Gong, Yanyan; Liu, Peter P.

In: New England Journal of Medicine, Vol. 355, No. 3, 20.07.2006, p. 260-269.

Research output: Contribution to journalArticle

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T1 - Outcome of heart failure with preserved ejection fraction in a population-based study

AU - Bhatia, R. Sacha

AU - Tu, Jack V.

AU - Lee, Douglas S.

AU - Austin, Peter C.

AU - Fang, Jiming

AU - Haouzi, Annick

AU - Gong, Yanyan

AU - Liu, Peter P.

PY - 2006/7/20

Y1 - 2006/7/20

N2 - Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent (heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent (heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure. Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days (5 percent vs. 7 percent, P = 0.08) and at 1 year (22 percent vs. 26 percent, P = 0.07); the adjusted one-year mortality rates were also not significantly different in the two groups (hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P = 0.18). The rates of readmission for heart failure and of in-hospital complications did not differ between the two groups. Conclusions: Among patients presenting with new-onset heart failure, a substantial proportion had an ejection fraction of more than 50 percent. The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction.

AB - Background: The importance of heart failure with preserved ejection fraction is increasingly recognized. We conducted a study to evaluate the epidemiologic features and outcomes of patients with heart failure with preserved ejection fraction and to compare the findings with those from patients who had heart failure with reduced ejection fraction. Methods: From April 1, 1999, through March 31, 2001, we studied 2802 patients admitted to 103 hospitals in the province of Ontario, Canada, with a discharge diagnosis of heart failure whose ejection fraction had also been assessed. The patients were categorized in three groups: those with an ejection fraction of less than 40 percent (heart failure with reduced ejection fraction), those with an ejection fraction of 40 to 50 percent (heart failure with borderline ejection fraction), and those with an ejection fraction of more than 50 percent (heart failure with preserved ejection fraction). Two groups were studied in detail: those with an ejection fraction of less than 40 percent and those with an ejection fraction of more than 50 percent. The main outcome measures were death within one year and readmission to the hospital for heart failure. Results: Thirty-one percent of the patients had an ejection fraction of more than 50 percent. Patients with heart failure with preserved ejection fraction were more likely to be older and female and to have a history of hypertension and atrial fibrillation. The presenting history and clinical examination findings were similar for the two groups. The unadjusted mortality rates for patients with an ejection fraction of more than 50 percent were not significantly different from those for patients with an ejection fraction of less than 40 percent at 30 days (5 percent vs. 7 percent, P = 0.08) and at 1 year (22 percent vs. 26 percent, P = 0.07); the adjusted one-year mortality rates were also not significantly different in the two groups (hazard ratio, 1.13; 95 percent confidence interval, 0.94 to 1.36; P = 0.18). The rates of readmission for heart failure and of in-hospital complications did not differ between the two groups. Conclusions: Among patients presenting with new-onset heart failure, a substantial proportion had an ejection fraction of more than 50 percent. The survival of patients with heart failure with preserved ejection fraction was similar to that of patients with reduced ejection fraction.

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