Longitudinal evaluation of ventricular ejection fraction and NT-proBNP across heart failure subgroups
(2018) In Scandinavian Cardiovascular Journal 52(4). p.205-210- Abstract
Objectives: Left ventricular ejection fraction (EF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are important surrogate markers of cardiac function and wall stress. Randomized trials of heart failure (HF) have shown improvements in survival in patients with reduced EF (<40%, HFrEF) but not with preserved EF (≥50%, HFpEF) or mid-range EF (40-49%, HFmrEF). Limited information is available on the trajectory of EF in contemporary heart failure management programs (HFMPs). Design: 201 HF patients consecutively enrolled 2010–2011 in the outpatient-based HFMP of Skåne University Hospital in Lund were included in the study. Probable etiology, EF, NT-proBNP and medications were assessed at baseline and 1 year after enrollment.... (More)
Objectives: Left ventricular ejection fraction (EF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are important surrogate markers of cardiac function and wall stress. Randomized trials of heart failure (HF) have shown improvements in survival in patients with reduced EF (<40%, HFrEF) but not with preserved EF (≥50%, HFpEF) or mid-range EF (40-49%, HFmrEF). Limited information is available on the trajectory of EF in contemporary heart failure management programs (HFMPs). Design: 201 HF patients consecutively enrolled 2010–2011 in the outpatient-based HFMP of Skåne University Hospital in Lund were included in the study. Probable etiology, EF, NT-proBNP and medications were assessed at baseline and 1 year after enrollment. Results: HFrEF was the most common heart failure subgroup (78.1% of patients) in this HFMP, followed by HFmrEF (14.9%) and HFpEF (7.0%). The most common etiology was ischemic heart disease (IHD, 40.8%). Complete recovery of EF (>50%) was rare (14.1% of patients with HFrEF and 26.7% with HFmrEF), some degree of improvement was observed in 57.7% and 46.7% of patients. LVEF improved on average 9.1% in patients with HFrEF (p < .001) and NT-proBNP decreased from 4,202 to 2,030 pg/ml (p < .001). A similar trend was noticed for the HFmrEF group but was not statistically significant. The improvement in LVEF was consistent across subgroups with HF attributable to IHD (6.2%), idiopathic dilated cardiomyopathy (7.1%) and tachycardia-induced HF (17.5%). Conclusions: This study provides estimates of the improvement in LVEF and NT-proBNP that can be expected with contemporary management across subgroups of HF and different etiologies in a contemporary HFMP.
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- author
- Martinsson, Andreas LU ; Oest, Petter ; Wiborg, Maj Britt ; Reitan, Öyvind LU and Smith, J. Gustav LU
- organization
- publishing date
- 2018-04-13
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ejection fraction, Heart failure, heart failure management program, heart failure therapy, NT-proBNP
- in
- Scandinavian Cardiovascular Journal
- volume
- 52
- issue
- 4
- pages
- 205 - 210
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:85045258267
- pmid:29656687
- ISSN
- 1401-7431
- DOI
- 10.1080/14017431.2018.1461920
- language
- English
- LU publication?
- yes
- id
- 01a01704-2b87-41a7-bc8b-e18e06715e24
- date added to LUP
- 2018-04-26 15:38:40
- date last changed
- 2024-06-10 11:54:03
@article{01a01704-2b87-41a7-bc8b-e18e06715e24, abstract = {{<p>Objectives: Left ventricular ejection fraction (EF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are important surrogate markers of cardiac function and wall stress. Randomized trials of heart failure (HF) have shown improvements in survival in patients with reduced EF (<40%, HFrEF) but not with preserved EF (≥50%, HFpEF) or mid-range EF (40-49%, HFmrEF). Limited information is available on the trajectory of EF in contemporary heart failure management programs (HFMPs). Design: 201 HF patients consecutively enrolled 2010–2011 in the outpatient-based HFMP of Skåne University Hospital in Lund were included in the study. Probable etiology, EF, NT-proBNP and medications were assessed at baseline and 1 year after enrollment. Results: HFrEF was the most common heart failure subgroup (78.1% of patients) in this HFMP, followed by HFmrEF (14.9%) and HFpEF (7.0%). The most common etiology was ischemic heart disease (IHD, 40.8%). Complete recovery of EF (>50%) was rare (14.1% of patients with HFrEF and 26.7% with HFmrEF), some degree of improvement was observed in 57.7% and 46.7% of patients. LVEF improved on average 9.1% in patients with HFrEF (p < .001) and NT-proBNP decreased from 4,202 to 2,030 pg/ml (p < .001). A similar trend was noticed for the HFmrEF group but was not statistically significant. The improvement in LVEF was consistent across subgroups with HF attributable to IHD (6.2%), idiopathic dilated cardiomyopathy (7.1%) and tachycardia-induced HF (17.5%). Conclusions: This study provides estimates of the improvement in LVEF and NT-proBNP that can be expected with contemporary management across subgroups of HF and different etiologies in a contemporary HFMP.</p>}}, author = {{Martinsson, Andreas and Oest, Petter and Wiborg, Maj Britt and Reitan, Öyvind and Smith, J. Gustav}}, issn = {{1401-7431}}, keywords = {{ejection fraction; Heart failure; heart failure management program; heart failure therapy; NT-proBNP}}, language = {{eng}}, month = {{04}}, number = {{4}}, pages = {{205--210}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Cardiovascular Journal}}, title = {{Longitudinal evaluation of ventricular ejection fraction and NT-proBNP across heart failure subgroups}}, url = {{https://lup.lub.lu.se/search/files/100027185/Martinsson_2018.pdf}}, doi = {{10.1080/14017431.2018.1461920}}, volume = {{52}}, year = {{2018}}, }