nach oben

Erschienen in:

28.06.2018 | Main topic

Heart failure with mid-range ejection fraction and with preserved ejection fraction

verfasst von: J. Petutschnigg, Univ.-Prof. Dr. med. F. Edelmann

Erschienen in: Herz | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

The annual “heart report” published by the German Heart Foundation (Deutsche Herzstiftung) in December 2017 indicates that heart failure (ICD I50) remains the number one diagnosis of in-hospital-treated patients throughout Germany. For some time, the clinical diagnosis of heart failure has been verified by echocardiographic parameters as well as cardiac biomarkers that assist the clinician to rule in or rule out the presence of a failing heart, when used wisely. By introducing the term “heart failure with mid-range ejection fraction” (HFmrEF), the 2016 European Society of Cardiology (ESC) heart failure guidelines established a third heart failure entity, which was not necessarily seen as an improvement by the heart failure community. Nevertheless, half of all patients suffering from heart failure are now classified as having HFmrEF or heart failure with preserved ejection fraction (HFpEF), but the etiology and treatment options differ substantially. To elucidate this issue, the current review aims to highlight the key findings published to date. This should minimize the confusion that may have been generated by the new term “HFmrEF”.

Report Deutsche Herzstiftung 2017/12

Lam CS, Solomon SD (2017) Fussing over the middle child: heart failure with mid-range ejection fraction. Circulation 135:1279–1280CrossRefPubMed

Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18:891–975

Packer M (2017) Heart failure with a mid-range ejection fraction A disorder that a psychiatrist would love. Jacc Heart Fail 5(11):805. https://doi.org/10.1016/j.jchf.2017.08.012 CrossRefPubMed

McMurray JJ, Adamopoulos S, Anker SD et al (2012) ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 33:1787–1847

Hsu JJ, Ziaeian B, Fonarow GC (2017) Heart failure with mid-range (borderline) ejection fraction: clinical implications and future directions. JACC Heart Fail 5(11):763–771CrossRefPubMed

Paulus WJ, Tschöpe C (2013) A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol 62:263–271CrossRefPubMed

Braunwald E (1997) Shattuck lecture—cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med 337:1360–1369CrossRefPubMed

Bhatia RS, Tu JV, Lee DS et al (2006) Outcome of heart failure with preserved ejection fraction in a population-based study. N Engl J Med 355:260–269CrossRefPubMed

10.

Kraigher-Krainer E, Shah AM, Gupta DK et al (2014) Impaired systolic function by strain imaging in heart failure with preserved ejection fraction. J Am Coll Cardiol 63(5):447–456CrossRefPubMed

11.

Shah AM, Claggett B, Loehr LR et al (2017) Heart failure stages among older adults in the community the atherosclerosis risk in communities study. Circulation 135:224–240CrossRefPubMed

12.

Lüers C, Edelmann F, Wachter R et al (2017) Prognostic impact of diastolic dysfunction in systolic heart failure—A cross-project analysis from the German Competence Network Heart Failure. Clin Cardiol 40(9):667–673CrossRefPubMed

13.

Bartle SH, Sanmarco ME (1966) Measurement of left ventricular volume by biplane angiocardiography and indicator-washout techniques: a comparison in the canine heart. Circ Res 19:295–306CrossRefPubMed

14.

Yancy CW, Jessup M, Bozkurt B et al (2013) 2013 ACCF/AHA Guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147–e239CrossRefPubMed

15.

Braunwald (2013) Heart failure. JACC Heart Fail 1:1–20CrossRefPubMed

16.

Nauta JF, Hummel YM, van Melle JP et al (2017) What have we learned about heart failure with mid-range ejection fraction one year after its introduction? Eur J Heart Fail 19:1569–1573CrossRefPubMed

17.

Komajda M, Lam CS (2014) Heart failure with preserved ejection fraction: a clinical dilemma. Eur Heart J 35:1022–1032CrossRefPubMed

18.

Campbell RT, Jhund PS, Castagno D et al (2012) What have we learned about patients with heart failure and preserved ejection fraction from DIG-PEF, CHARM-preserved, and I‑PRESERVE? J Am Coll Cardiol 60(23):2349–2356CrossRefPubMed

19.

Roger VL (2013) Epidemiology of Heart Failure. Circ Res 113:646–659CrossRefPubMedPubMedCentral

20.

Steinberg BA, Zhao X, Heidenreich PA et al (2012) Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulatio 126:65–75CrossRef

21.

Bhambhani V, Kizer JR, Lima JAC et al (2018) Predictors and outcomes of heart failure with mid-range ejection fraction. Eur J Heart Fail 20:651–659CrossRefPubMed

22.

Vedin O, Lam CSP, Koh AS et al (2017) Significance of ischemic heart disease in patients with heart failure and preserved, midrange, and reduced ejection fraction: a nationwide cohort study. Circ Heart Fail 10:e3875CrossRefPubMed

23.

Chioncel O, Lainscak M, Seferovic PM et al (2017) Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail 19:1574–1585CrossRefPubMed

24.

Rickenbacher P, Kaufmann BA, Maeder MT et al (2017) Heart failure with mid-range ejection fraction: a distinct clinical entity? Insights from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF). Eur J Heart Fail 19:1586–1596CrossRefPubMed

25.

Gohar A, Chong JPC, Liew OW et al (2017) The prognostic value of highly sensitive cardiac troponin assays for adverse events in men and women with stable heart failure and a preserved vs. reduced ejection fraction. Eur J Heart Fail 19:1638–1647CrossRefPubMed

26.

Savarese G, Hage C, Orsini N et al (2016) Reductions in N‑terminal pro-brain natriuretic peptide levels are associated with lower mortality and heart failure hospitalization rates in patients with heart failure with mid-range and preserved ejection fraction. Circ Heart Fail 9:e3105CrossRefPubMed

27.

Tromp J, Khan MAF, Mentz RJ et al (2017) Biomarker profiles of acute heart failure patients with a mid-range ejection fraction. J Am Coll Cardiol Heart Fail 5:507–517

28.

Tromp J, Khan MA, Klip IT et al (2017) Biomarker profiles in heart failure patients with preserved and reduced ejection fraction. J Am Heart Assoc 6:e3989CrossRefPubMedPubMedCentral

29.

Watson CJ, Gupta SK, O’Connell E et al (2015) MicroRNA signatures differentiate preserved from reduced ejection fraction heart failure. Eur J Heart Fail 17:405–415CrossRefPubMedPubMedCentral

30.

Deschaseaux C, McSharry M, Hudson E et al (2016) Treatment initiation patterns, modifications, and medication adherence among newly diagnosed heart failure patients: a retrospective claims database analysis. J Manag Care Spec Pharm 22(5):561–571CrossRefPubMed

31.

Bayés-Genís A, Núñez J, Lupón J (2017) Heart failure with mid-range ejection fraction: a transition phenotype? Eur J Heart Fail 19(12):1635–1637CrossRefPubMed

32.

Tsuji K, Sakata Y, Nochioka K et al (2017) Characterization of heart failure patients with mid-range left ventricular ejection fraction—a report from the CHART-2 Study. Eur J Heart Fail 19:1258–1269CrossRefPubMed

33.

Lund LH, Claggett B, Liu J et al (2018) Heart failure with mid-range ejection fraction in CHARM: characteristics, outcomes and effect of candesartan across the entire ejection fraction spectrum. Eur J Heart Fail. https://doi.org/10.1002/ejhf.1149 CrossRefPubMed

34.

Lund LH, Benson L, Dahlström U et al (2012) Association between use of renin-angiotensin system antagonists and mortality in patients with heart failure and preserved ejection fraction. JAMA 308:2108–2117CrossRefPubMed

35.

Cleland JGF, Bunting KV, Flather MD et al (2018) Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. Eur Heart J 39(1):26–35CrossRefPubMed

36.

Pitt B, Pfeffer MA, Assmann SF et al (2014) Spironolactone for heart failure with preserved ejection fraction. N Engl J Med 370:1383–1392CrossRefPubMed

37.

Solomon SD, Claggett B, Lewis EF et al (2016) Influence of ejection fraction on outcomes and efficacy of spironolactone in patients with heart failure with preserved ejection fraction. Eur Heart J 37:455–462CrossRefPubMed

38.

Owan TE, Hodge DO, Herges RM et al (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med 355:251–259CrossRefPubMed

39.

Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) (2012) The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data metaanalysis. Eur Heart J 33:1750–1757CrossRef

40.

Cleland JG, Pellicori P (2013) Defining diastolic heart failure and identifying effective therapies. JAMA 309(8):825–826CrossRefPubMed

41.

Faris RF, Flather M, Purcell H et al (2012) Diuretics for heart failure. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003838.pub3 PubMedCrossRef

42.

Faris R, Flather M, Purcell H et al (2002) Current evidence supporting the role of diuretics in heart failure: a meta analysis of randomised controlled trials. Int J Cardiol 82:149–158CrossRefPubMed

43.

Senni M, Paulus WJ, Gavazzi A et al (2014) New strategies for heart failure with preserved ejection fraction: the importance of targeted therapies for heart failure phenotypes. Eur Heart J 35:2797–2811CrossRefPubMedPubMedCentral

44.

Bergström A, Andersson B, Edner M et al (2004) Effect of carvedilol on diastolic function in patients with diastolic heart failure and preserved systolic function. Results of the Swedish Doppler-echocardiographic study (SWEDIC). Eur J Heart Fail 6:453–461CrossRefPubMed

45.

Conraads VM, Metra M, Kamp O et al (2012) Effects of the long-term administration of nebivolol on the clinical symptoms, exercise capacity, and left ventricular function of patients with diastolic dysfunction: results of the ELANDD study. Eur J Heart Fail 14:219–225CrossRefPubMed

46.

American College of Cardiology (2018) Annual scientific session. Presentation, pp 405–410

47.

Ahmed A, Rich MW, Fleg JL et al (2006) Effects of digoxin on morbidity and mortality in diastolic heart failure: the ancillary Digitalis Investigation Group trial. Circulation 114:397–403CrossRefPubMedPubMedCentral

48.

Guazzi M, Vicenzi M, Arena R et al (2011) Pulmonary hypertension in heart failure with preserved ejection fraction: a target of phosphodiesterase-5 inhibition in a 1-year study. Circulation 124:164–174CrossRefPubMed

49.

Redfield MM, Chen HH, Borlaug BA et al (2013) RELAX trial. Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction: a randomized clinical trial. JAMA 309:1268–1277CrossRefPubMed

50.

Bonderman D, Pretsch I, Steringer-Mascherbauer R et al (2014) Acute hemodynamic effects of riociguat in patients with pulmonary hypertension associated with diastolic heart failure (DILATE-1): a randomized, double- blind, placebo-controlled, single-dose study. Chest. 146(5):1274-1285. https://doi.org/10.1378/chest.14-0106 CrossRefPubMedPubMedCentral

51.

Pieske B, Maggioni AP, Lam CSP et al (2017) Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. Eur Heart J 38:1119–1127CrossRefPubMedPubMedCentral

52.

Maier LS, Layug B, Karwatowska-Prokopczuk E et al (2013) Ranolazine for the treatment of diastolic heart failure in patients with preserved ejection fraction: the RALI-DHF proof of-concept study. JACC Heart Fail 1:115–122CrossRefPubMed

53.

Komajda M, Isnard R, Cohen-Solal A et al (2017) Effect of ivabradine in patients with heart failure with preserved ejection fraction: the EDIFY randomized placebo-controlled trial. Eur J Heart Fail 19:1495–1503CrossRefPubMed

54.

Khan MS, Fonarow GC, Khan H et al (2017) Renin–angiotensin blockade in heart failure with preserved ejection fraction: a systematic review and meta-analysis. ESC Heart Fail 4:402–408CrossRefPubMedPubMedCentral

55.

Pfeffer MA, Claggett B, Assmann SF et al (2015) Regional variation in patients and outcomes in the treatment of preserved cardiac function heart failure with an aldosterone antagonist (TOPCAT) trial. Circulation 131:34–42CrossRefPubMed

56.

Girerd N, Ferreira JP, Rossignol P et al (2016) A tentative interpretation of the TOPCAT trial based on randomized evidence from the brain natriuretic peptide stratum analysis. Eur J Heart Fail 18:1411–1414CrossRefPubMed

57.

Desai AS, Jhund PS (2016) After TOPCAT: what to do now in heart failure with preserved ejection fraction. Eur Heart J 37:3135–3140CrossRefPubMed

58.

Anand IS, Rector TS, Cleland JG et al (2011) Prognostic value of baseline plasma amino-terminal pro-brain natriuretic peptide and its interactions with irbesartan treatment effects in patients with heart failure and preserved ejection fraction: findings from the I‑PRESERVE trial. Circ Heart Fail 4:569–577CrossRefPubMed

59.

Anand IS, Claggett B, Liu J et al (2017) Interaction between spironolactone and natriuretic peptides in patients with heart failure and preserved ejection fraction: from the TOPCAT trial. JACC Heart Fail 5:241–252CrossRefPubMed

60.

Solomon SD, Zile M, Pieske B et al (2012) Prospective comparison of ARNI with ARB on management of heart failure with preserved ejection fraction (PARAMOUNT) investigators. The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial. Lancet 380:1387–1395

61.

Solomon SD, Rizkala AR, Gong J et al (2017) Angiotensin receptor neprilysin inhibition in heart failure with preserved ejection fraction: rationale and design of the PARAGON-HF trial. JACC Heart Fail 5(7):471–482CrossRefPubMed

62.

Butler J, Hamo CE, Filippatos G et al (2017) The potential role and rationale for treatment of heart failure with sodium-glucose co-transporter 2 inhibitors. Eur J Heart Fail 19:1390–1400CrossRefPubMed

63.

Weber KT, Brilla CG (1991) Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system. Circulation 83:1849–1865CrossRefPubMed

64.

Brilla CG, Zhou G, al Matsubara Let (1994) Collagen metabolism in cultured adult rat cardiac fibroblasts: response to angiotensin II and aldosterone. J Mol Cell Cardiol 26:809–820CrossRefPubMed

65.

López-Andrés N, Martin-Fernandez B, Rossignol P et al (2011) A role for cardiotrophin-1 in myocardial remodeling induced by aldosterone. Am J Physiol Heart Circ Physiol 301:H2372–H2382CrossRefPubMed

66.

Mottram PM, Haluska B, Leano R et al (2004) Effect of aldosterone antagonism on myocardial dysfunction in hypertensive patients with diastolic heart failure. Circulation 110:558–565CrossRefPubMed

67.

Deswal A, Richardson P, Bozkurt B et al (2011) Results of the randomized aldosterone antagonism in heart failure with preserved ejection fraction trial (RAAM-PEF). J Card Fail 17:634–642CrossRefPubMed

68.

Edelmann F, Wachter R, Schmidt AG et al (2013) Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA 309:781–791CrossRefPubMed

69.

Lund LH, Oldgren J, James S et al (2017) Registry-based pragmatic trials in heart failure: current experience and future directions. Curr Heart Fail Rep 14:59–70CrossRefPubMedPubMedCentral

70.

Cleland JG, Daubert JC, Erdmann E et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352:1539–1549CrossRefPubMed

71.

Hutchinson K, Pellicori P, Dierckx R et al (2014) Remote telemonitoring for patients with heart failure: might monitoring pulmonary artery pressure become routine? Expert Rev Cardiovasc Ther 12(8):1025–1033CrossRefPubMed

72.

Linde C, Curtis AB, Fonarow GC et al (2016) Cardiac resynchronization therapy in chronic heart failure with moderately reduced left ventricular ejection fraction: Lessons from the Multicenter InSync Randomized Clinical Evaluation MIRACLE EF study. Int J Cardiol 202:349–355CrossRefPubMed

73.

Kass DA, Kitzman DW, Alvarez GE (2010) The restoration of chronotropic competence in heart failure patients with preserved ejection fraction (RESET) study: rationale and design. J Card Fail 16(1):17–24CrossRefPubMed

74.

National Institutes of Health (2018) Clinicaltrials.gov. Restoration of chronotropic competence in heart failure patients with normal ejection fraction (RESET). https://clinicaltrials.gov/ct2/show/NCT00670111. Accessed: 22 June 2018

75.

Sandoval J, Gaspar J, Peña H et al (2011) Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension. Eur Respir J 38:1343–1348CrossRefPubMed

76.

Chiu JS, Zuckerman WA, Turner ME et al (2015) Balloon atrial septostomy in pulmonary arterial hypertension: effect on survival and associated outcomes. J Heart Lung Transplant 34:376–380CrossRefPubMed

77.

Barst RJ (2000) Role of atrial septostomy in the treatment of pulmonary vascular disease. Thorax 55(2):95–96CrossRefPubMedPubMedCentral

78.

Hasenfuss G, Gustafsson F, Kaye D et al (2015) Rationale and design of the reduce elevated left atrial pressure in patients with heart failure (reduce LAP-HF) trial. J Cardiac Fail 21(7):594–600CrossRef

79.

Hasenfuß G, Hayward C, Burkhoff D et al (2016) A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicentre, open-label, single-arm, phase 1 trial. Lancet 387:1298–1304CrossRefPubMed

80.

Abraham WT, Kuck KH, Goldsmith RL et al (2018) A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation. Jacc Heart Fail. https://doi.org/10.1016/j.jchf.2018.04.010 CrossRefPubMed

81.

Cardiac Contractility Modulation (CCM™) (2018) Therapy in subjects with heart failure with preserved ejection fraction. https://clinicaltrials.gov/ct2/show/NCT03240237. Accessed: 22 June 2018

82.

Patel HC, Rosen SD, Hayward C et al (2016) Renal denervation in heart failure with preserved ejection fraction (RDT-PEF): a randomized controlled trial. Eur J Heart Fail 18:703–712CrossRefPubMed

83.

Georgakopoulos D, Little WC, Abraham WT et al (2011) Chronic baroreflex activation: a potential therapeutic approach to heart failure with preserved ejection fraction. J Card Fail 17(2):167–178CrossRefPubMed

84.

Abraham WT, Zile MR, Weaver FA et al (2015) Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction. JACC Heart Fail 3(6):487–496CrossRefPubMed

85.

Kraigher-Krainer E, Lyass A, Massaro JM et al (2013) Association of physical activity and heart failure with preserved vs. reduced ejection fraction in the elderly: the Framingham Heart Study. Eur J Heart Fail 15:742–746CrossRefPubMedPubMedCentral

86.

Edelmann F, Gelbrich G, Düngen HD et al (2011) Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction results of the ex-DHF (exercise training in diastolic heart failure) pilot study. J Am Coll Cardiol 58(17):1780–1791CrossRefPubMed

87.

Kitzman DW, Brubaker P, Morgan T et al (2016) Effect of caloric restriction or aerobic exercise training on peak oxygen consumption and quality of life in obese older patients with heart failure with preserved ejection fraction – A randomized clinical trial. JAMA 315(1):36–46CrossRefPubMedPubMedCentral

88.

Edelmann F, Bobenko A, Gelbrich G et al (2017) Exercise training in Diastolic Heart Failure (Ex-DHF): rationale and design of a multicentre, prospective, randomized, controlled, parallel group trial. Eur J Heart Fail 19:1067–1074CrossRefPubMed

89.

Bobenko A, Bartels I, Münch M et al (2018) Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction. ESC Heart Fail 5:53–62CrossRefPubMed

Titel: Heart failure with mid-range ejection fraction and with preserved ejection fraction
verfasst von: J. Petutschnigg
Univ.-Prof. Dr. med. F. Edelmann
Publikationsdatum: 28.06.2018
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 5/2018
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-018-4729-8

Neu im Fachgebiet Kardiologie

23.04.2024 | Ablationstherapie | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Heart failure with mid-range ejection fraction and with preserved ejection fraction

Abstract

Neu im Fachgebiet Kardiologie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Kardiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2018

Interatrial septum versus right atrial appendage pacing for prevention of atrial fibrillation

Peripartum cardiomyopathy

Current drug therapy for heart failure with reduced ejection fraction

Heart failure 2.0 or 0.1?

Association of soluble ST2 with functional capacity in outpatients with heart failure

Relationship between inducible NOS single-nucleotide polymorphisms and hypertension in Han Chinese

Neu im Fachgebiet Kardiologie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Kardiologie