Patients With Heart Failure and Comorbid Chronic Inflammatory Diseases Exhibit Differing Disease Subtypes and Trajectories

A review of longitudinal data revealed that patients with heart failure (HF) and various chronic inflammatory diseases (CIDs) exhibited differing HF subtypes and left ventricular ejection fraction (LVEF) trajectories over time. These findings were published in Circulation: Heart Failure.

Electronic medical records of patients who underwent echocardiogram at Northwestern Medicine health system affiliates between 2000 and 2019 were analyzed for this study. Longitudinal HF trajectories observed during ³3 LVEF measurements were compared between patients with rheumatoid arthritis (RA; n=116), systematic sclerosis (SSc; n=112), systematic lupus erythematosus (SLE; n=106), psoriasis (n=83), HIV (n=74), inflammatory bowel disease (IBD; n=50), and patients without a CID (n=433).

The patients with a CID tended to be younger (mean, 60.8 vs 66.4), were less White (50.8% vs 66.0%), had lower LVEF at HF diagnosis (mean, 48.8% vs 55.1%), and had more HF hospital admissions (median, 7.0 vs 2.0).

In general, patients with SSc had higher baseline LVEF (b, 0.31; 95% CI, 0.20-0.43; P <.001) and patients with IBD were more likely to have LVEF recovery over time (b, 0.15; 95% CI, 0.005-0.30; P =.043) compared with controls.

A longitudinal LVEF trajectory of HF with preserved or moderately reduced EF was more likely among patients with IBD (P <.001), SLE (P =.003), and RA (P =.012) and HF with recovered EF among patients with RA (P =.022). It was less likely for patients with IBD (P <.001), RA (P =.012), and SLE (P =.027) to have a trajectory of HF with reduced EF and for patients with SLE (P <.001) and psoriasis (P =.002), a trajectory of HF with recovered EF.

These data were sourced from a single health care system in a single region and may not be generalizable to the general population.

The study authors concluded that HF subtypes and LVEF trajectories appeared to be affected by comorbid CIDs indicating that underlying pathophysiologic processes are likely occurring. Additional study of HF among patients with CIDs is needed to better understand clinical patterns and outcomes among these patient populations.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Rivera AS, Sinha A, Ahmad FS, et al. Long-term trajectories of left ventricular ejection fraction in patients with chronic inflammatory diseases and heart failure: an analysis of electronic health records. Circ Heart Fail. 2021;14(8):e008478. doi:10.1161/CIRCHEARTFAILURE.121.008478