Table 2.
Baseline and follow‐up main demographic, clinical, echocardiographic, and therapeutic characteristics according to GDMT changes
| Baseline | Follow‐up | |||||
| GDMT downtitrated (n = 40, 33%) | GDMT uptitrated/unchanged (n = 81, 67%) | P value | GDMT downtitrated (n = 40, 33%) | GDMT uptitrated/unchanged (n = 81, 67%) | P value | |
| Age (years) | 65 ± 14 | 68 ± 11 | 0.166 | 65 ± 14 | 68 ± 11 | 0.170 |
| Male gender (%) | 78 | 77 | 0.907 | — | — | — |
| BMI (kg/m2) | 25.3 ± 4.3 | 25.9 ± 4.3 | 0.459 | — | — | — |
| Logistic Euroscore (%) | 17 ± 16 | 21 ± 16 | 0.147 | — | — | — |
| N° CLIPS ≥ 2 (%) | 68 | 63 | 0.624 | — | — | — |
| COPD (%) | 18 | 15 | 0.703 | — | — | — |
| Diabetes (%) | 28 | 37 | 0.297 | — | — | — |
| Hypertension (%) | 48 | 64 | 0.060 | — | — | — |
| PAD (%) | 23 | 27 | 0.581 | — | — | — |
| IHD (%) | 48 | 59 | 0.221 | — | — | — |
| Previous HF hospitalization (%) | 70 | 70 | 0.967 | — | — | — |
| NYHA class ≥3 (%) | 85 | 93 | 0.189 | 43 | 25 | 0.049 |
| NYHA class (%) | ||||||
| I | 0 | 0 | 0.480 | 5 | 9 | 0.483 |
| II | 15 | 7 | 0.112 | 52 | 66 | 0.140 |
| III | 58 | 74 | 0.065 | 32 | 21 | 0.189 |
| IV | 27 | 19 | 0.258 | 11 | 4 | 0.156 |
| HR (bpm) | 68.8 ± 14 | 68.8 ± 12.8 | 0.998 | 71 ± 14 | 72 ± 15 | 0.739 |
| SBP (mmHg) | 112 ± 15 | 11 ± 18 | 0.726 | 108 ± 19 | 110 ± 14 | 0.380 |
| DBP (mmHg) | 67 ± 8 | 67 ± 9 | 0.734 | 66 ± 8 | 67 ± 7 | 0.478 |
| BNP (pg/mL) | 1054 (489–1684) | 528 (319–1510) | 0.665 | 818 (341–1257) | 638 (328–1596) | 0.943 |
| GFR (mL/min/m2) | 52 (40–78) | 48 (33–70) | 0.437 | 56 (37–73) | 46 (30–68) | 0.207 |
| GFR < 60 mL/min/m2 (%) | 63 | 67 | 0.651 | 54 | 65 | 0.285 |
| Hb (g/dL) | 11.6 ± 2.5 | 12 ± 1.7 | 0.315 | — | — | — |
| History of AF (%) | 55 | 42 | 0.176 | — | — | — |
| LVEDD (mm) | 67 ± 14 | 67 ± 11 | 0.961 | 67.5 ± 10 | 65.2 ± 10 | 0.284 |
| LVEDV (mL) | 213.7 ± 74.2 | 213.7 ± 64.5 | 0.999 | 216 ± 89 | 195 ± 63 | 0.160 |
| LVESV (mL) | 150 ± 63 | 149 ± 53 | 0.883 | 162 ± 79 | 133 ± 51 | 0.040 |
| LVEF (%) | 30.7 ± 7.5 | 30.9 ± 7.3 | 0.922 | 26.7 ± 10.6 | 29.3 ± 7.9 | 0.152 |
| LAA (cm2) | 34.3 ± 13 | 36.4 ± 11 | 0.514 | 34.7 ± 11 | 34.3 ± 9.3 | 0.881 |
| PASP (mmHg) | 49 ± 14.2 | 48 ± 12.5 | 0.749 | 42 ± 13.2 | 40.6 ± 12 | 0.450 |
| RV dysfunction (%) | 65 | 53 | 0.213 | 39 | 46 | 0.564 |
| TR ≥ 2+ (%) | 40 | 42 | 0.836 | 30 | 17 | 0.267 |
| MR severity (%) | ||||||
| 1+ | 0 | 0 | N.C. | 20 | 27 | 0.470 |
| 2+ | 0 | 0 | N.C. | 40 | 50 | 0.331 |
| 3+ | 28 | 30 | 0.808 | 26 | 19 | 0.650 |
| 4+ | 72 | 70 | 0.808 | 14 | 4 | 0.058 |
| Medical therapy/device | ||||||
| Furosemide dose (mg) | 195 ± 148 | 170 ± 129 | 0.361 | 157 ± 134 | 160 ± 130 | 0.899 |
| Loop diuretics (%) | 100 | 100 | N.C | 100 | 100 | N.C |
| Reduced diuretic dose at follow‐up (%) | — | — | — | 24 | 27 | 0.680 |
| Increased diuretic dose at follow‐up (%) | — | — | — | 42 | 37 | 0.551 |
| No change in diuretic dose at follow‐up (%) | — | — | — | 34 | 36 | 0.821 |
| Beta‐blockers (%) | 80 | 88 | 0.266 | 73 | 90 | 0.013 |
| Beta‐blockers quartile of target dose (%) | ||||||
| <25% | 20 | 12 | 0.266 | 26 | 9 | 0.012 |
| 25% to <50% | 5 | 24 | 0.012 | 21 | 23 | 0.833 |
| 50% to <75% | 35 | 36 | 0.931 | 37 | 39 | 0.803 |
| 75% to 100% | 40 | 28 | 0.199 | 16 | 29 | 0.118 |
| ACEI/ARB/ARNI (%) | 83 | 68 | 0.090 | 73 | 83 | 0.192 |
| ACEI/ARB/ARNI quartile of target dose (%) | ||||||
| <25% | 17 | 32 | 0.090 | 30 | 17 | 0.109 |
| 25% to <50% | 5 | 15 | 0.112 | 25 | 19 | 0.407 |
| 50% to <75% | 30 | 27 | 0.744 | 33 | 32 | 0.965 |
| 75% to 100% | 48 | 26 | 0.018 | 12 | 32 | 0.020 |
| MRA (%) | 67 | 78 | 0.220 | 65 | 73 | 0.375 |
| ICD (%) | 73 | 70 | 0.808 | 80 | 74 | 0.473 |
| CRT (%) | 38 | 39 | 0.854 | 40 | 39 | 0.935 |
ACEI, angiotensin‐converting enzyme inhibitors; AF, atrial fibrillation; ARB, angiotensin receptor blockers; ARNI, angiotensin receptor neprlisyn inhibitors; BMI, body mass index; BNP, B‐type natriuretic peptide; bpm, beats per minute; COPD, chronic obstructive pulmonary disease; CRT, cardiac resynchronization therapy; DBP, diastolic blood pressure; GDMT, guideline‐directed medical therapy; GFR, glomerular filtration rate; Hb, haemoglobin; HF, heart failure; HR, heart rate; ICD, implantable cardioverter defibrillator; IHD, ischaemic heart disease; LAA, left atrial area; LVEDD, left ventricle end‐diastolic diameter; LVEDV, left ventricular end‐diastolic volume; LVEF, left ventricular ejection fraction; LVESV, left ventricular end‐systolic volume; MR, mitral regurgitation; MRA mineral corticoid antagonists; NYHA, New York Heart Association; PAD, peripheral artery disease; PASP pulmonary artery systolic pressure; RV, right ventricle; SBP systolic blood pressure; TR, tricuspid regurgitation.
In bold are P values < 0.05.