Improvement in Left Ventricular Ejection Fraction in Outpatients With Heart Failure With Reduced Ejection Fraction
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- Adam D. DeVore
- Duke Clinical Research Institute, Durham, NC (A.D.D., A.S.H., L.T., A.F.H.).
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- Anne S. Hellkamp
- Duke Clinical Research Institute, Durham, NC (A.D.D., A.S.H., L.T., A.F.H.).
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- Laine Thomas
- Duke Clinical Research Institute, Durham, NC (A.D.D., A.S.H., L.T., A.F.H.).
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- Nancy M. Albert
- Cleveland Clinic, OH (N.M.A.).
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- Javed Butler
- University of Mississippi Medical Center, Jackson (J.B.).
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- J. Herbert Patterson
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill (J.H.P.).
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- John A. Spertus
- Saint Luke’s Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City, MO (J.A.S.).
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- Fredonia B. Williams
- Mended Hearts, Huntsville, AL (F.B.W.).
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- Carol I. Duffy
- Novartis Pharmaceuticals Corporation, East Hanover, NJ (C.I.D.).
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- Adrian F. Hernandez
- Duke Clinical Research Institute, Durham, NC (A.D.D., A.S.H., L.T., A.F.H.).
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- Gregg C. Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA (G.C.F.).
書誌事項
- タイトル別名
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- Data From CHAMP-HF
説明
<jats:sec> <jats:title>Background:</jats:title> <jats:p>Among patients with heart failure (HF) with reduced ejection fraction (EF), improvements in left ventricular EF (LVEF) are associated with better outcomes and remain an important treatment goal. Patient factors associated with LVEF improvement in routine clinical practice have not been clearly defined.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>CHAMP-HF (Change the Management of Patients with Heart Failure) is a prospective registry of outpatients with HF with reduced EF. Assessments of LVEF are recorded when performed for routine care. We analyzed patients with both baseline and ≥1 follow-up LVEF assessments to describe factors associated with LVEF improvement.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>In CHAMP-HF, 2623 patients had a baseline and follow-up LVEF assessment. The median age was 67 (interquartile range, 58–75) years, 40% had an ischemic cardiomyopathy, and median HF duration was 2.8 years (0.7–6.8). Median LVEF was 30% (23–35), and median change on follow-up was 4% (−2 to −13); 19% of patients had a decrease in LVEF, 31% had no change, 49% had a ≥5% increase, and 34% had a ≥10% increase. In a multivariable model, the following factors were associated with ≥5% LVEF increase: shorter HF duration (odds ratio [OR], 1.21 [95% CI, 1.17–1.25]), no implantable cardioverter defibrillator (OR, 1.46 [95% CI, 1.34–1.55]), lower LVEF (OR, 1.15 [95% CI, 1.10–1.19]), nonischemic cardiomyopathy (OR, 1.24 [95% CI, 1.09–1.36]), and no coronary disease (OR, 1.20 [95% CI, 1.03–1.35]).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>In a large cohort of outpatients with chronic HF with reduced EF, improvements in LVEF were common. Common baseline cardiac characteristics identified a population that was more likely to respond over time. These data may inform clinical decision making and should be the basis for future research on myocardial recovery.</jats:p> </jats:sec>
収録刊行物
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- Circulation: Heart Failure
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Circulation: Heart Failure 13 (7), 2020-07
Ovid Technologies (Wolters Kluwer Health)