Kenmerken van asymptomatische patiënten met hartfalen en verminderde ejectiefractie

INTRODUCTION: The majority of clinical studies investigating patients with heart failure and a reduced ejection fraction (HFrEF) exclusively included patients with symptomatic heart failure. There is a paucity of information concerning the clinical characteristics, progression to symptomatic heart failure, heart failure hospitalization rates and survival in patients with asymptomatic systolic left ventricular dysfunction (ASLVD). We address this knowledge gap by describing the baseline characteristics of participants in the prospective observational TransitionCHF study of patients with reduced left ventricular Function in New York Heart Association (NYHA) functional Class I and comparing them to those of other recent trials in HFrEF. METHODS: In total, 1005 individuals with ASLVD NYHA I with an ejection fraction ≤ 40% were recruited. Patient characteristics were compared with other studies involving patients with symptomatic heart failure. Multivariable linear regression and Pearson coefficients were used to determine the association between quality of life, mental health, markers of organ function, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) plasma levels, and exercise performance. RESULTS: The mean age of participants was 60 ± 14 years and 18% were women. The mean ejection fraction was 36% and the mean left ventricular end-diastolic diameter was 59 mm. When compared with studies involving patients with symptomatic heart failure, the age was ≈ 5 years younger and the frequency of comorbidities was lower. The Short Form Health Survey-36 physical functioning score was moderately correlated with the Maastricht Vital Exhaustion Questionnaire (MQ; r = -0.44 and weakly with 6-min walking distance (r = 0.32), peak VO2 at ergospirometry (r = 0.28), and Heart Focus Anxiety (HAF17; r = -0.34). NT-proBNP levels showed a weak association with peak VO2 (r = -0.29) and the 6-min walk distance (r = -0.21). CONCLUSIONS: Patients included in the TransitionCHF study are younger and suffer from fewer comorbidities as compared with symptomatic heart failure patients. Associations between NT-proBNP levels and markers of exercise performance were weak.