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Heart Failure with Preserved vs. Reduced Ejection Fraction: Patient Characteristics, In-hospital Treatment and Mortality—DanAHF, a Nationwide Prospective Study

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Abstract

This study aims to describe baseline characteristics and in-hospital management of a patient cohort hospitalized with acute heart failure (AHF). Adult patients in Denmark admitted with a medical diagnosis during a 7-day period were reviewed for symptoms and clinical findings suggestive of AHF. HFpEF was defined as LVEF ≥ 45%. Of 5194 patients, 290 (6%) had AHF. Sixty-two percent (n = 179) was diagnosed with HFpEF. Compared to HFrEF patients, HFpEF patients were more often women (48% vs. 31%, p = 0.004), less likely to have ischemic heart disease (31% vs. 53%, p = 0.002) and a pacemaker/ICD (7% vs. 21%, p < 0.001/1% vs. 8%, p < 0.001). Fewer HFpEF patients received intravenous diuretics (43% vs. 73%, p < 0.001) and inotropes (2% vs. 7%, p = 0.02), while more HFpEF patients received nitro-glycerine (59% vs. 44%, p = 0.02). Intubation/NIV, ICU admission, and revascularization were used similarly. Hospitalization was shorter for HFpEF patients (4 vs. 6 days, p < 0.001), with no significant difference in survival to discharge (96% vs. 91%, p = 0.07). Of AHF admissions, nearly two-thirds was due to HFpEF. Compared to HFrEF, HFpEF patients had a lower cardiac comorbidity and a 2-day shorter hospitalization.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ACEI :

ACE-inhibitor

ARB :

Angiotensin receptor blockers

BMI :

Body mass index

CABG :

Coronary artery bypass graft

CAG :

Coronary angiography

COPD :

Chronic obstructive pulmonary disease

HF :

Heart failure

HFpEF :

Heart failure with preserved ejection fraction

HFrEF :

Heart failure with reduced ejection fraction

ICD :

Implantable cardioverter defibrillator

ICU :

Intensive care unit

IHD :

Ischemic heart disease

LVEF :

Left ventricular ejection fraction

MRA :

Aldosterone antagonists

NIV :

Non-invasive ventilation

PCI :

Percutaneous coronary intervention

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Acknowledgements

The authors wish to thank all the nurses, who helped collecting data.

Funding

This work was supported by Novartis, unrestricted grant (F-22963–01).

Author information

Authors and Affiliations

  1. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark

    Maria Lassen, Helle Søholm & Matias Greve Lindholm

  2. Department of Anaesthesiology and Intensive Care, Bispebjerg Hospital, Copenhagen, Denmark

    Maria Lassen

  3. Department of Cardiology, Hvidovre Hospital, Copenhagen, Denmark

    Ekim Seven

  4. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

    Christian Hassager & Jacob Eifer Møller

  5. University of Copenhagen, Copenhagen, Denmark

    Christian Hassager

  6. Department of Cardiology, Odense University Hospital, Odense, Denmark

    Jacob Eifer Møller

  7. University of Southern Denmark, Odense, Denmark

    Jacob Eifer Møller

  8. Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark

    Nana Valeur Køber

Authors
  1. Maria Lassen
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  7. Matias Greve Lindholm
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Contributions

ML interpreted the data and drafted the work. ES analyzed the data and revised the work. HS was a major contributor in writing the manuscript. CH and JM substantively revised the work. NK and MGL designed and revised the work. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Maria Lassen.

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Ethics Approval and Consent to Participate

The DanAHF study and data collection has been authorized by the Danish Health and Medicines Authorities.

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Not applicable.

Competing Interests

The authors declare no competing interests.

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Associate Editor Jozine ter Maaten oversaw the review of this article.

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Lassen, M., Seven, E., Søholm, H. et al. Heart Failure with Preserved vs. Reduced Ejection Fraction: Patient Characteristics, In-hospital Treatment and Mortality—DanAHF, a Nationwide Prospective Study. J. of Cardiovasc. Trans. Res. 17, 265–274 (2024). https://doi.org/10.1007/s12265-023-10385-7

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  • DOI: https://doi.org/10.1007/s12265-023-10385-7

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