Author + information
- Vincenzo Tufaro,
- Francesco Bandera,
- Greta Generati,
- Eleonora Alfonzetti and
- Marco Guazzi
Background: Newly released European Guidelines proposed a new classification of heart failure (HF) introducing the mid-range ejection fraction (mEF) phenotype with a left ventricular EF ranging from 40-49%. The aim of this study was to evaluate HFmEF patients compared to heart failure with reduced ejection fraction (HFrEF, LVEF < 40%) by studying functional capacity pattern and hemodynamics by echocardiography.
Methods: we retrospectively identified HF patients with LVEF < 50% who underwent rest and exercise echocardiography combined to cardiopulmonary exercise test (CPET).
Results: 164 patients (120 males, mean age 65.1 + 11.2) were included in the study. 119 patients had HFrEF (mean LVEF 30 + 6.5%, mean age 64.9 + 11.4), 45 patients as HFmEF (mean LVEF 44.8 + 4.1%, mean age 65.4 + 10.5). Both groups presented with ischemic cardiomyopathy as leading HF cause. NYHA class III was more frequent in patients with HFrEF. Table reports a worse LV remodeling, mitral regurgitation, filling pressure, right ventricular to pulmonary circulation coupling pattern, worse oxygen consumption and ventilation efficiency despite similar cardiac output at rest and during exercise.
Conclusions: The new definition clearly discriminates two distinct “functional” syndromes. HFmEF patients demonstrate a worse LV remodeling, RV function and a worse functional capacity. Impairment in exercise performance does not seem to be related to cardiac output but rather to abnormalities in ventilation efficiency.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Applications of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1160-219
- 2017 American College of Cardiology Foundation