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Heart failure and systolic function: time to leave diagnostics based on ejection fraction?

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Graphical Abstract Graphical abstract (A and B) Prediction of 1-year mortality by LVEF measured during rest (A) and by maximum cardiac power during dobutamine stress (B) in patients with severe… Click to show full abstract

Graphical Abstract Graphical abstract (A and B) Prediction of 1-year mortality by LVEF measured during rest (A) and by maximum cardiac power during dobutamine stress (B) in patients with severe acute or chronic heart failure. Means ± SD. For LVEF, there is considerable overlap, whereas maximum cardiac power differentiates well between survivors and non-survivors. An open circle indicates cardiac transplanted and open squares indicate sudden deaths. Modified from Tan.8 (C) Data from the SHOCK Trial Registry showing that cardiac power was a strong predictor of mortality in cardiogenic shock. Modified from Fincke et al.9 (D) Five-year mortality was similar in heart failure patients with preserved, borderline, and reduced ejection fraction. Modified from Shah et al.10 (E) Illustration of a patient during stress echocardiography with a semi-supine bicycle. (F) Five-year Kaplan–Meier survival curves for mortality stratified by quartiles of peak stress cardiac power/mass. Patients with the lowest cardiac power/mass in quartile 1 had the worst survival followed by quartiles 2 and 3, and was the best in quartile 4. Adjusted for age, sex, peak metabolic equivalents, diabetes mellitus, and diastolic function at baseline. Reproduced from Anand et al.1

Keywords: cardiac power; ejection fraction; heart; heart failure

Journal Title: European Heart Journal
Year Published: 2021

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