Print Get Citation Citation Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. Please consult the latest official manual style if you have any questions regarding the format accuracy. AMA Citation Dougherty B, Chan A. Dougherty B, & Chan A Dougherty, Brian, and Alex Chan. Deterioration of left ventricular ejection fraction to mid-range ejection fraction associated with increased mortality and cardiovascular events. 2 Minute Medicine, 23 June 2020. McGraw-Hill, 2020. AccessMedicine. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=550770§ionid=248315760APA Citation Dougherty B, Chan A. Dougherty B, & Chan A Dougherty, Brian, and Alex Chan. (2020). Deterioration of left ventricular ejection fraction to mid-range ejection fraction associated with increased mortality and cardiovascular events. (2020). 2 minute medicine. McGraw-Hill. https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=550770§ionid=248315760.MLA Citation Dougherty B, Chan A. Dougherty B, & Chan A Dougherty, Brian, and Alex Chan. "Deterioration of left ventricular ejection fraction to mid-range ejection fraction associated with increased mortality and cardiovascular events." 2 Minute Medicine McGraw-Hill, 2020, https://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=550770§ionid=248315760. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Clip Full Chapter Figures Only Tables Only Videos Only Supplementary Content Top Deterioration of left ventricular ejection fraction to mid-range ejection fraction associated with increased mortality and cardiovascular events by Brian Dougherty, Alex Chan Listen +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +1. Heart failure patients whose EF deteriorated from ≥50% to between 40% and 50% were at an increased risk of mortality and cardiovascular events +Evidence Level Rating: 2 (Good) +Clinicians use left ventricular ejection fraction (LVEF) to guide treatment of heart failure (HF). Patients with HF are commonly divided into two separate and clinically distinct cohorts, those with an EF <40% having “heart failure with reduced ejection fraction” (HFrEF) and those with an EF ≥50% having “heart failure with persevered ejection fraction” (HFpEF). This categorization, however, fails to account for patients with an EF between 40% and 50%, sometimes classified as having “heart failure with mid-range ejection fraction” (HFmrEF). The aim of this study was to determine future risk of cardiovascular events based on a prior transition into the HFmrEF group, either by reduction or increase in EF from a previous measurement. Primary outcomes included all-cause mortality, cardiovascular mortality, and all-cause hospitalization, among others. Using health records from the UC San Diego Health System, 448 patients with HFmrEF were identified and followed over an additional two years to track outcomes. 157 patients (M [SD] age = 63.8 [8.1] years, 63.7% male, 54.7% white) improved, 67 patients (M [SD] age = 66.6 [9.8] years, 75.0% male, 64.0% white) remained stable, and 224 patients (M [SD] age = 70.9 [9.5] years, 56.3% male, 62.5% white) deteriorated with regards to their EF prior to inclusion. A 1.34-fold increase in the risk of combined all-cause mortality and hospitalization was seen in the deteriorated group (p = 0.03). The deteriorated group was also at a significantly increased risk of cardiovascular death or hospitalization for HF (HR 1.71, 95% CI 1.08 to 2.50, p = 0.02). Both findings were consistent after adjusting for age, sex, and comorbidity. In contrast, there was no significant difference in risk for any of the primary outcomes between patients in the improved and stable groups even after adjustment. Overall, this study suggests that the directional change of EF in HFmrEF patients has implications for future clinical course and could be used to guide and tailor therapy. +Click to read the study in JAMA Cardiology +©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.