Heart failure as a cause of hospitalization in IPF: comparison of the HFpEF, HFrEF, and PH

Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and fibrosing lung disease. Some IPF patients require hospitalization because of heart failure (HF), including HF with preserved ejection fraction (HFpEF), HF with reduced ejection fraction (HFrEF), and HF due to pulmonary hypertension (HFPH). However, the association between IPF and HF has not been clarified. We retrospectively investigated the clinical features and outcomes of patients with IPF and HF. Methods We examined the data of patients with IPF who were admitted for HF to the Kindai University Hospital from January 2008 to December 2018. Results During the study period, 37 patients with IPF were hospitalized because of HF. Among the 34 patients finally included in the study, 17 (50.0%) were diagnosed with HFpEF, 6 (17.6%) with HFrEF, and 11 (32.3%) with HFPH. Patients with HFrEF had significantly higher values for B-type natriuretic peptide (BNP), and left ventricular (LV) end-systolic and end-diastolic diameters than patients with HFpEF and HFPH (BNP: P = 0.01 and P = 0.0004, LV end-systolic diameter: P < 0.0001 and P < 0.0001, and LV end-diastolic diameter: P = 0.01 and P = 0.0004, respectively). Notably, the difference between the LVEFs of the patients with HFpEF or HFPH was not significant. The patients with HFpEF had the best 30-day mortality rate (0%, P = 0.02). Conclusions In patients with IPF, HFpEF is the most common type of HF that requires nonelective hospitalization. Patients with HFpEF survived longer than patients with the 2 other types of HF.