Effective Treatments for Heart Failure with Reduced Ejection Fraction Sorely Needed

A recent study provided much needed insights on traditional heart failure with preserved ejection fraction (HFpEF).

HFpEF is known to be difficult to treat, and the terminology used to describe the condition is not largely agreed upon in the medical community. However, the cases of HFpEF are expected to bypass the amount of patients with traditional heart failure with a reduced ejection fraction (HFrEF).

“There is a need for studies that analyze HFpEF on a national scale, capable of reporting on the population's inherent heterogeneity using a broadly inclusive cohort, as such studies offer the promise of filling the gaps of knowledge that remain in the understanding of HFpEF, a disease process that still lacks proven therapies," said lead investigator Parag Goyal, MD.

HFpEF is typically characterized by a stiff ventricle and patients usually have hypertension, diabetes, lung disease, or chronic renal failure, according to the study, which was published by The American Journal of Medicine.

The researchers examined data for over 5 million hospitalizations for acute heart failure. Patients included were at least 18-years-old, and were hospitalized for acute heart failure between 2003 and 2012.

They found that 46% of patients were diagnosed with HFpEF, and 54% were diagnosed with HFrEF. Researchers found that patients with HFpEF were likely to be women, and aged 75 years or older with other medical conditions.

Patients with pulmonary hypertension had the highest incidence of in-hospital mortality. Patients with treatable conditions had the smallest incidence of in-hospital mortality.

Researchers also found that men had a higher rate of in-hospital mortality compared with women, meaning that HFpEF could potentially be more severe in men. Blacks also had lower in-hospital mortality than whites, which could be related to a younger population of blacks presenting HFpEF, according to the study.

“Whether these key differences stem from disproportionately inadequate treatment of hypertension in blacks or racial differences in left ventricular adaptive mechanisms warrants further investigation,” Dr Goyal said.

Although more information about HFpEF has been discovered, an effective treatment strategy for this population is still needed, the researchers concluded.