Key result
Heart failure with preserved ejection fraction is associated with poor clinical outcomes that are explained by the heart failure syndrome itself rather than age, sex, or comorbidities.
Why the study?
Comparisons of outcomes in patients with reduced and preserved ejection fraction heart failure across DIG, CHARM, and I-PRESERVE trials and other comorbidity trials provide insights into phenotype and clinical outcomes.
Answers are grounded in this paper and cite their sources.
Comparative trial analysis reveals high mortality and hospitalization in heart failure with preserved ejection fraction, indicating outcomes stem from the heart failure syndrome itself.
Examination of patients with reduced and preserved ejection fraction in the DIG (Digitalis Investigation Group) trials and the CHARM (Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity) trials provides comparisons of outcomes in each of these types of heart failure. Comparison of the patients in these trials, along with the I-PRESERVE (Irbesartan in Heart Failure with Preserved Systolic Function Trial), with patients of similar age, sex distribution, and comorbidity in trials of hypertension, diabetes mellitus, angina pectoris, and atrial fibrillation provides even more interesting insights into the relation between phenotype and rates of death and heart failure hospitalization. The poor clinical outcomes in patients with heart failure and preserved ejection fraction do not seem easily explained on the basis of age, sex, comorbidity, blood pressure, or left ventricular structural remodeling but do seem to be explained by the presence of the syndrome of heart failure.
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Campbell et al. (2012) conducted a review in Heart failure with preserved ejection fraction. Heart failure with preserved ejection fraction vs. Patients with similar demographics and comorbidities in other disease trials was evaluated on Rates of death and heart failure hospitalization. Heart failure with preserved ejection fraction is associated with poor clinical outcomes that are explained by the heart failure syndrome itself rather than age, sex, or comorbidities.
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