A research study examining different types of heart failure has allowed doctors to identify heart failure patients who may survive longer with proper care. The study was done by a group of researchers including Professor Arthur Mark Richards, director of the Cardiovascular Research Institute at the National University Health System (NUHS), and Professor Tan Huay Cheem, director of the National University Heart Centre, Singapore (NUHCS). Both professors also hold appointments in NUS Medicine.
The study identified the ejection fraction as the deciding factor, which refers to the amount of blood pumped out when the heart contracts. It is also a key determinant of heart failure, which occurs when the heart is unable to provide a normal supply of blood to the body, organs and tissues. Approximately one-third of the 50,000 heart failure patients in Singapore have preserved ejection fraction, which means that their hearts squeeze well, but do not relax as well, causing less blood to get in. Preserved ejection fraction is more common among female and older patients, and patients with preserved ejection fraction are likely to survive longer with proper care.
It was also discovered that levels of a hormone in the blood produced by the heart is a powerful and independent indicator of death, regardless of the type of heart failure. Aware that patients with preserved ejection fraction possess better survival rates, doctors could now devote more attention to lowering the levels of this hormone for these patients.
And while it is often difficult for doctors and patients to accept the number of drugs, usually three, to get the patients to the ideal hormone levels, the results of this study may mean that doctors can now prescribe these drugs with more confidence, according to Prof Richards.