Impact of peripheral edema on outcomes of heart failure according to ejection fraction
S Hwang, J R Park, J Y Hwang, J S Koh, M G Kang, H R Kim, H G Kim, K H KimAbstract
Background
Peripheral edema is one of the most representative signs of heart failure but considerable portions of heart failure patients dose not present with edema. Effect of peripheral edema on outcomes in heart failure is not fully evaluated yet. Therefore this study examined impact of peripheral edema on outcomes of heart failure patients according ejection fraction.
Methods
This is retrospective study from the third Nationwide Korean Heart Failure III Registry (KorHF III) in which 7351 patients with acute heart failure was prospectively enrolled from 47 tertiary hospitals between March 2018 and December 2022, with a 2-year follow-up. In this study, patients were grouped into with and without peripheral edema. The edema data was reported in 2,412 patients and in these patients, clinical, echocardiographic and laboratory characteristics were compared according to presence of edema and primary outcome was death and transplantation until follow-up.
Results
Patients with edema(n=388) were more obese, more frequently have atrial fibrillation, more anemic but lesser have history of ischemic heart disease compared to patients without edema(n=2,204). Albumin was lower and uric acid was higher in blood test in patients with edema. In echo, patients with edema showed smaller LV size, higher ejection fraction and higher TR velocity. Primary outcome of death and transplantation was not different in patients with and without edema (Figure 1). However when outcomes were compared according to heart failure types by ejection fraction, primary outcome was not different in patients HFrEF with and without edema but worse outcome was observed in HFpEF patients with edema compared to without edema(Figure 2).
Conclusion
Peripheral edema was associated with worse outcomes in HFpEF patients but not in HFrEF, suggesting more concerns for edema in these heart failure subtype.Figure 1For image description, please refer to the figure legend and surrounding text.Figure 2For image description, please refer to the figure legend and surrounding text.