Table 1.
Baseline demographics and clinical characteristics of the enrolled heart failure patients stratified by the directional change in LVEF.
| Characteristics | All patients (n = 1,168) | Improved group (n = 310) | Stable group (n = 334) | Deteriorated group (n = 524) | P-value |
|---|---|---|---|---|---|
| Age (years) | 63.60 ± 12.18 | 60.08 ± 13.08Ψ† | 62.92 ± 12.10*† | 66.11 ± 11.09*Ψ | <0.0001 |
| Male (n, %) | 783 (67.04%) | 226 (72.90%)† | 237 (70.96%)† | 320 (61.07%)*Ψ | 0.0004 |
| Systolic blood pressure (mmHg) | 136.2 ± 23.33 | 133.0 ± 22.22† | 136.3 ± 23.25 | 138.0 ± 23.86* | 0.0118 |
| Diastolic blood pressure (mmHg) | 80.46 ± 13.77 | 81.85 ± 14.11† | 80.77 ± 13.23 | 79.43 ± 13.84* | 0.0437 |
| Heart rates | 82.21 ± 22.02 | 85.76 ± 21.03† | 82.60 ± 22.87 | 79.85 ± 21.79* | 0.0009 |
| Body weight (kg) | 73.77 ± 13.26 | 75.84 ± 15.13† | 74.38 ± 13.10 | 72.22 ± 11.97* | 0.0037 |
| Body mass index (kg/m2) | 26.15 ± 4.034 | 26.66 ± 4.1 | 25.29 ± 3.70 | 26.27 ± 4.15 | 0.5814 |
| Prior NYHA class III–IV (n, %) | 322 (27.56%) | 84 (27.10%) | 95 (28.44%) | 143 (27.29%) | 0.9126 |
| NYHA class III–IV at the time of inclusion (n, %) | 406 (34.76%) | 89 (28.70%)Ψ† | 130 (38.92%)* | 187 (35.68%)* | 0.0204 |
| Comorbidities | |||||
| Coronary artery disease (n, %) | 633 (54.20%) | 148 (47.74%)Ψ† | 187 (55.99%)* | 298 (56.87%)* | 0.0258 |
| Atrial fibrillation (n, %) | 310 (26.54%) | 67 (21.61%) | 93 (27.84%) | 150 (28.63%) | 0.0699 |
| Cancer (n, %) | 52 (5.65%) | 10 (3.26%)† | 15 (4.49%) | 41 (7.82%)* | 0.0116 |
| Cerebrovascular disease (n, %) | 179 (15.33%) | 36 (11.61%) | 55 (16.47%) | 88 (16.79%) | 0.1055 |
| Diabetes mellitus (n, %) | 414 (35.45%) | 97 (31.29%) | 125 (37.43%) | 192 (36.54%) | 0.1980 |
| Hypertension (n, %) | 719 (61.56%) | 166 (53.55%)Ψ† | 211 (63.17%)* | 342 (65.27%)* | 0.0027 |
| Therapy | |||||
| ACEI/ARB/ARNI (n, %) | 652 (55.82%) | 187 (60.32%)† | 197 (58.98%)† | 268 (51.15%)*Ψ | 0.0139 |
| Aspirin (n, %) | 683 (58.48%) | 176 (56.77%) | 209 (62.57%) | 298 (56.87%) | 0.1982 |
| Beta-blockers (n, %) | 885 (75.77%) | 266 (85.81%)Ψ† | 267 (79.94%)*† | 352 (67.18%)*Ψ | <0.0001 |
| Digoxin (n, %) | 154 (13.18%) | 62 (20.00%)† | 36 (10.78%)* | 56 (10.69%)* | 0.0002 |
| Loop diuretics (n, %) | 432 (36.99%) | 145 (46.77%)Ψ† | 121 (36.23%)* | 166 (31.69%)* | <0.0001 |
| Nitrates (n, %) | 438 (37.50%) | 103 (33.23%)Ψ | 144 (43.11%)* | 191 (36.45%) | 0.0280 |
| Spironolactone (n, %) | 596 (51.03%) | 227 (73.23%)Ψ† | 173 (51.80%)*† | 196 (37.40%)*Ψ | <0.0001 |
| Statins (n, %) | 763 (65.33%) | 197 (63.55%) | 235 (70.36%) | 331 (63.17%) | 0.0726 |
| Warfarin (n, %) | 226 (19.35%) | 55 (17.74%)† | 52 (15.57%)† | 119 (22.71%)*Ψ | 0.0252 |
| Pacemaker (n, %) | 81 (6.93%) | 14 (4.52%) | 22 (6.59%) | 45 (8.59%) | 0.0784 |
| ICD (n, %) | 18 (1.54%) | 8 (2.58%) | 5 (1.50%) | 5 (0.95%) | 0.1825 |
| CRT (n, %) | 22 (1.88%) | 14 (4.52%)Ψ† | 5 (1.50%)* | 3 (0.57%)* | 0.0002 |
| Laboratory values | |||||
| White blood cell (10∧9/L) | 7.655 ± 3.135 | 8.061 ± 3.386† | 7.595 ± 3.007 | 7.452 ± 3.042* | 0.0231 |
| Hemoglobin (g/L) | 136.9 ± 21.64 | 141.1 ± 21.85Ψ† | 136.9 ± 20.66* | 134.4 ± 21.77* | <0.0001 |
| Platelet (10∧9/L) | 208.7 ± 66.64 | 222.4 ± 80.98Ψ† | 202.0 ± 59.32* | 205.0 ± 60.34* | 0.0001 |
| Creatinine (μmol/L) | 76.00 (62.00, 97.00) | 79 (64.25, 99.00) | 76.00 (63.00, 98.00) | 74.00 (61.00, 95.00) | 0.6160 |
| UA (μmol/L) | 409.4 ± 138.0 | 440.9 ± 161.1Ψ† | 412.5 ± 131.9* | 390.3 ± 124.5* | <0.0001 |
| Na+ (mmol/L) | 141.7 ± 3.130 | 141.6 ± 3.169 | 141.6 ± 3.021 | 141.7 ± 3.179 | 0.7728 |
| Glu (mmol/L) | 6.351 ± 2.614 | 6.370 ± 2.853 | 6.373 ± 2.489 | 6.326 ± 2.560 | 0.9619 |
| D-dimer (μg/L) | 420 (210.0, 970.0) | 410 (210.0, 970.0) | 410 (190.0 880.0) | 455.0 (230.0, 1,025) | 0.2193 |
| BNP level (ng/L) | 317.5 (119.9, 779.4) | 506.7 (183.5, 1,168)† | 337.4 (127.0, 922.1)† | 231.2 (90.40, 517.9)*Ψ | <0.0001 |
| Echocardiography parameters | |||||
| Time interval (months) | 16.00 (7.250, 29.00) | 12.00 (6.000, 26.00)† | 13.50 (7.000, 27.00)† | 19.00 (10.00, 31.00)*Ψ | <0.0001 |
| Prior echocardiography findings | |||||
| Left ventricular ejection fraction (%) | 46.26 ± 10.57 | 32.41 ± 5.626Ψ† | 43.61 ± 2.711*† | 56.16 ± 3.088*Ψ | <0.0001 |
| Left ventricular diameter (mm) | 53.52 ± 7.875 | 59.69 ± 7.213Ψ† | 54.22 ± 6.706*† | 49.61 ± 6.466*Ψ | <0.0001 |
| Left atrial diameter (mm) | 42.44 ± 7.225 | 44.02 ± 6.313Ψ† | 42.64 ± 6.711*† | 41.44 ± 7.838*Ψ | <0.0001 |
| Interventricular septal thickness (mm) | 10.68 ± 1.914 | 10.38 ± 1.661Ψ† | 10.80 ± 1.951* | 10.78 ± 2.007* | 0.0103 |
| E/e′ | 13.02 ± 5.621 | 13.46 ± 5.383 | 13.47 ± 6.075 | 12.38 ± 5.372 | 0.0534 |
| Echocardiography findings at the time of inclusion | |||||
| Left ventricular ejection fraction (%) | 43.75 ± 2.875 | 43.35 ± 2.874† | 43.70 ± 2.757 | 44.02 ± 2.925* | 0.0047 |
| Left ventricular diameter (mm) | 53.92 ± 6.604 | 56.24 ± 6.259Ψ† | 54.78 ± 6.759*† | 51.84 ± 6.076*Ψ | <0.0001 |
| Left atrial diameter (mm) | 42.85 ± 6.782 | 42.28 ± 6.630 | 43.52 ± 6.433 | 42.77 ± 7.079 | 0.0682 |
| Interventricular septal thickness (mm) | 10.76 ± 1.998 | 10.55 ± 1.871 | 10.73 ± 2.153 | 10.90 ± 1.960 | 0.0568 |
| E/e′ | 13.07 ± 5.628 | 12.19 ± 5.645 | 13.18 ± 5.344 | 13.49 ± 5.770 | 0.0668 |
NYHA, New York Heart Association; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; ARNI, angiotensin receptor neprilysin inhibitor; ICD, implantable cardioverter defibrillator; CRT, cardiac resynchronization therapy; BNP, B-type natriuretic peptide; Glu, glucose; UA, uric acid; E/e′, mitral Doppler early velocity/mitral annular early velocity.
*
is compared with Improved group P < 0.05,
Ψ
is compared with Stable group P < 0.05,
†
is compared with Deteriorated group P < 0.05.