Does Heart Failure with Preserved Ejection Fraction have a different prognosis that Heart failure with reduced ejection fraction?

Introduction :

The heart Failure Center of Beth Shemech received patients with severe heart failure since 2013. Two cardiologists and two nurses treat more than 100 patients. The majority of these patients need IV diuretic on a regular basis on top of all the oral medications which have been validated in the treatment of advanced heart failure.

Methods

Heart failure with preserved left ventricular fraction (HFPEF) is defined by an ejection fraction above 50%. Heart failure with a reduced left ventricular fraction (HFREF)is defined by an ejection fraction below 50 %. Fifty-three patients are treated for HFPEF and 49 patients for HFREF.

Results :

No difference was found between HFPEF and HFREF concerning the presence of diabetes mellitus, chronic renal failure or coronary artery disease. No difference was found between HFPEF and HFREF concerning the oral medications ( Beta-blockers, Angiotensin-converting enzyme inhibitors, diuretics, spironolactone and IV diuretics). More patients with HFREF have a Right ventricular reduced function than patients with HFPEF ( 2% versus 31%). But no difference was found between associated valvular disease like mitral regurgitation, tricuspid regurgitation and pulmonary hypertension between the two types of heart failure. The most striking results are that the mortality 8% for HPEF and 9% for HFREF is the same.

Conclusion

This study confirms the fact that heart failure with preserved ejection fraction has the same bad prognosis than Heart Failure with a reduced fraction in spite of the marked difference in right ventricular systolic dysfunction.