Heart Failure With Recovered Ejection Fraction in African Americans

Results From the African-American Heart Failure Trial

Kay Won Chang, Neil Beri, Nghia H. Nguyen, Boris Arbit, Sutton Fox, Sean Mojaver, Paul Clopton, S. William Tam, Anne L. Taylor, Jay N Cohn, Alan S. Maisel, Inder Anand

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up. Methods and Results: Subjects with HFrecEF (improvement in EF from <35% to >40% in 6 months; n = 59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40% at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02–1.15; P =.068), fewer 1st HF hospitalizations (HR 0.22, 95% CI 0.07–0.71; P =.011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05–0.37; P <.001), similar 1st all-cause hospitalizations (HR 0.67, 95% CI 0.39–1.15; P =.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95% CI 0.24–0.68; P <.001). Conclusions: These data confirm that, as in other populations, a small subgroup of black patients receiving standard care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients.

Original languageEnglish (US)
Pages (from-to)303-309
Number of pages7
JournalJournal of cardiac failure
Volume24
Issue number5
DOIs
StatePublished - May 1 2018

Fingerprint

African Americans
Heart Failure
Hospitalization
Confidence Intervals
Mortality
Population

Keywords

  • African American
  • Heart failure
  • black
  • hydralazine
  • isosorbide dinitrate
  • recovered ejection fraction

Cite this

Heart Failure With Recovered Ejection Fraction in African Americans : Results From the African-American Heart Failure Trial. / Chang, Kay Won; Beri, Neil; Nguyen, Nghia H.; Arbit, Boris; Fox, Sutton; Mojaver, Sean; Clopton, Paul; Tam, S. William; Taylor, Anne L.; Cohn, Jay N; Maisel, Alan S.; Anand, Inder.

In: Journal of cardiac failure, Vol. 24, No. 5, 01.05.2018, p. 303-309.

Research output: Contribution to journalArticle

Chang, KW, Beri, N, Nguyen, NH, Arbit, B, Fox, S, Mojaver, S, Clopton, P, Tam, SW, Taylor, AL, Cohn, JN, Maisel, AS & Anand, I 2018, 'Heart Failure With Recovered Ejection Fraction in African Americans: Results From the African-American Heart Failure Trial', Journal of cardiac failure, vol. 24, no. 5, pp. 303-309. https://doi.org/10.1016/j.cardfail.2017.09.005
Chang, Kay Won ; Beri, Neil ; Nguyen, Nghia H. ; Arbit, Boris ; Fox, Sutton ; Mojaver, Sean ; Clopton, Paul ; Tam, S. William ; Taylor, Anne L. ; Cohn, Jay N ; Maisel, Alan S. ; Anand, Inder. / Heart Failure With Recovered Ejection Fraction in African Americans : Results From the African-American Heart Failure Trial. In: Journal of cardiac failure. 2018 ; Vol. 24, No. 5. pp. 303-309.
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abstract = "Background: Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up. Methods and Results: Subjects with HFrecEF (improvement in EF from <35{\%} to >40{\%} in 6 months; n = 59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40{\%} at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95{\%} confidence interval [CI] 0.02–1.15; P =.068), fewer 1st HF hospitalizations (HR 0.22, 95{\%} CI 0.07–0.71; P =.011), fewer recurrent HF hospitalizations (HR 0.13, 95{\%} CI 0.05–0.37; P <.001), similar 1st all-cause hospitalizations (HR 0.67, 95{\%} CI 0.39–1.15; P =.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95{\%} CI 0.24–0.68; P <.001). Conclusions: These data confirm that, as in other populations, a small subgroup of black patients receiving standard care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients.",
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T2 - Results From the African-American Heart Failure Trial

AU - Chang, Kay Won

AU - Beri, Neil

AU - Nguyen, Nghia H.

AU - Arbit, Boris

AU - Fox, Sutton

AU - Mojaver, Sean

AU - Clopton, Paul

AU - Tam, S. William

AU - Taylor, Anne L.

AU - Cohn, Jay N

AU - Maisel, Alan S.

AU - Anand, Inder

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N2 - Background: Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up. Methods and Results: Subjects with HFrecEF (improvement in EF from <35% to >40% in 6 months; n = 59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40% at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02–1.15; P =.068), fewer 1st HF hospitalizations (HR 0.22, 95% CI 0.07–0.71; P =.011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05–0.37; P <.001), similar 1st all-cause hospitalizations (HR 0.67, 95% CI 0.39–1.15; P =.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95% CI 0.24–0.68; P <.001). Conclusions: These data confirm that, as in other populations, a small subgroup of black patients receiving standard care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients.

AB - Background: Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population-specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the 1st 6 months of follow-up. Methods and Results: Subjects with HFrecEF (improvement in EF from <35% to >40% in 6 months; n = 59) were compared with 259 subjects with heart failure and persistently reduced EF (HFrEF), defined as EF ≤40% at 6-month follow-up. The effects of improvement in EF on all-cause mortality and 1st and all hospitalizations were analyzed. Compared with HFrEF, subjects with HFrecEF had a nonsignificant trend toward lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02–1.15; P =.068), fewer 1st HF hospitalizations (HR 0.22, 95% CI 0.07–0.71; P =.011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05–0.37; P <.001), similar 1st all-cause hospitalizations (HR 0.67, 95% CI 0.39–1.15; P =.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95% CI 0.24–0.68; P <.001). Conclusions: These data confirm that, as in other populations, a small subgroup of black patients receiving standard care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients.

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