Implications of Peripheral Oedema in Heart Failure with Preserved Ejection Fraction: A Heart Failure Network Analysis
Key result
In hospitalized patients with HFpEF, moderate or greater oedema did not significantly increase the rate of 60-day rehospitalization or death compared to mild or no oedema (HR 1.44; 95% CI 0.87-2.39; P=0.156).
Why the study?
HFpEF is a heterogeneous condition where tissue congestion manifested by oedema is not present in all patients, prompting comparison of clinical characteristics, exercise capacity, and outcomes.
Does the presence of peripheral oedema affect clinical characteristics, exercise capacity, and outcomes in patients with HFpEF?
Population
393 ambulatory and 338 hospitalized HFpEF patients with LVEF ≥50%
Comparison
Patients with oedema vs without oedema
Authors
Discussion
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Implication
Moderate oedema does not predict 60-day events in hospitalized HFpEF; hypothesis-generating and should not yet guide discharge decisions.
Study Design
Type
Observational (n=731)
Multicenter
Yes
Structured PICO
Does the presence of peripheral oedema affect clinical characteristics, exercise capacity, and outcomes in patients with HFpEF?
P
Population
731 patients with HFpEF (LVEF ≥50%) from pooled clinical trials, divided into ambulatory (n=393) and hospitalized (n=338) cohorts to assess the impact of oedema.
E
Exposure
Presence of oedema (ambulatory cohort) or ≥moderate oedema (hospitalized cohort)
C
Comparator
Absence of oedema (ambulatory cohort) or mild/no oedema (hospitalized cohort)
O
Outcome
Clinical characteristics, exercise capacity (peak VO2), symptom improvement (dyspnoea visual analogue scale), and 60-day rehospitalization or deathcomposite
Main Result
Hazard Ratio: 1.44 (95% CI 0.87–2.39)
p-value: p=0.156
In patients with HFpEF, peripheral oedema is associated with higher BMI, more comorbidities, and worse exercise intolerance, but does not significantly alter short-term clinical outcomes or treatment response.
Cite This Study
Fudim et al. (2020) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=731). Oedema vs. Without oedema (or mild/none) was evaluated on 60 day rehospitalization/death (HR 1.44, 95% CI 0.87-2.39, p=0.156). In hospitalized patients with HFpEF, moderate or greater oedema did not significantly increase the rate of 60-day rehospitalization or death compared to mild or no oedema (HR 1.44; 95% CI 0.87-2.39; P=0.156).