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<p>Because heart failure (HF) with preserved ejection fraction (HFpEF) is mainly a disease of elderly, there are a few reports focusing young patients. This study aims to elucidate characteristics of comparatively young HFpEF patients. We divided HFpEF patients in PURSUIT–HFpEF registry into younger HFpEF group (age ≤ 65 years) and older HFpEF group and compared the all-cause mortality and HF readmission (HFR) between the two groups and identified discharge factors correlated with HFR among younger HFpEF patients. The younger HFpEF group comprised 51 patients (4.1%). In this group, body mass index and smoking were significantly higher, while hypertension was significantly lower compared to older HFpEF group. Kaplan–Meier analysis indicated no significant difference in HFR between the groups, although all-cause mortality was significantly lower in younger HFpEF group (p &lt; 0.001). Multivariable Cox proportional hazards analysis indicated that angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) were inversely correlated with HFR, whereas mineralocorticoid receptor antagonists (MRA) were positively correlated with HFR in younger HFpEF patients (p = 0.004 and p = 0.007, respectively). In conclusion, younger HFpEF is rare (approximately 4%), with obesity and smoking being significant modifiable factors. HFR was similar between younger and older HFpEF patients. Administration of ACEI/ARB and unnecessity of MRA at discharge may be associated with reducing HFR in younger HFpEF patients.</p>

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Characteristics of comparatively young heart failure with preserved ejection fraction: PurSuit–HFpEF registry

  • 期刊论文

  • 发表日期：

    2025年4月15日

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  • Masami Nishino,
  • Yasuyuki Egami,
  • Ayako Sugino,
  • Noriyuki Kobayashi,
  • Masaru Abe,
  • Mizuki Ohsuga,
  • Hiroaki Nohara,
  • Shodai Kawanami,
  • Kohei Ukita,
  • Akito Kawamura,
  • Koji Yasumoto,
  • Naotaka Okamoto,
  • Yasuharu Matsunaga-Lee,
  • Masamichi Yano,
  • Takahisa Yamada,
  • Yoshio Yasumura,
  • Masahiro Seo,
  • Takaharu Hayashi,
  • Akito Nakagawa,
  • Yusuke Nakagawa,
  • Shunsuke Tamaki,
  • Katsuki Okada,
  • Yohei Sotomi,
  • Daisaku Nakatani,
  • Shungo Hikoso,
  • Yasushi Sakata

摘要

Because heart failure (HF) with preserved ejection fraction (HFpEF) is mainly a disease of elderly, there are a few reports focusing young patients. This study aims to elucidate characteristics of comparatively young HFpEF patients. We divided HFpEF patients in PURSUIT–HFpEF registry into younger HFpEF group (age ≤ 65 years) and older HFpEF group and compared the all-cause mortality and HF readmission (HFR) between the two groups and identified discharge factors correlated with HFR among younger HFpEF patients. The younger HFpEF group comprised 51 patients (4.1%). In this group, body mass index and smoking were significantly higher, while hypertension was significantly lower compared to older HFpEF group. Kaplan–Meier analysis indicated no significant difference in HFR between the groups, although all-cause mortality was significantly lower in younger HFpEF group (p < 0.001). Multivariable Cox proportional hazards analysis indicated that angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) were inversely correlated with HFR, whereas mineralocorticoid receptor antagonists (MRA) were positively correlated with HFR in younger HFpEF patients (p = 0.004 and p = 0.007, respectively). In conclusion, younger HFpEF is rare (approximately 4%), with obesity and smoking being significant modifiable factors. HFR was similar between younger and older HFpEF patients. Administration of ACEI/ARB and unnecessity of MRA at discharge may be associated with reducing HFR in younger HFpEF patients.