Clinical Scorecard: Seasonal Patterns and Severe Cold Exposure in Heart Failure With Mildly Reduced Ejection Fraction
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Seasonal Patterns and Severe Cold Exposure in Heart Failure With Mildly Reduced Ejection Fraction
Key Mechanisms
Admission season was not associated with 30-day mortality; extreme cold at admission and over the preceding 3-day mean was associated with higher adjusted 30-day mortality. The authors discuss preserved contractile reserve in HFmrEF as one possible explanation for the absence of a seasonal signal.
Target Population
Patients included in the source article's study population.
Care Setting
Care setting described in the source article.
Key Highlights
Admissions were distributed almost equally across spring, summer, autumn, and winter, without discernible winter predominance.
Admission season was not associated with 30-day all-cause mortality (log-rank p = 0.809).
Admission-day temperature in the lowest 5th percentile (≤0.8 °C) was associated with higher adjusted 30-day mortality (HR 2.012; 95% CI 1.003–4.033; p = 0.049).
Extreme cold based on the preceding 3-day mean temperature (≤1.33 °C) was also associated with higher adjusted 30-day mortality (HR 2.058; 95% CI 1.028–4.118; p = 0.042).
Extreme high ambient temperature and day-to-day temperature fluctuation in the top 5th percentile were not associated with 30-day mortality.
Guideline-Based Recommendations
Diagnosis
The study defined HFmrEF as LVEF 41–49%; it did not evaluate diagnostic criteria.
Management
Discharge prescriptions for HF pharmacotherapies were comparable across seasons (all p > 0.10); the study did not test treatment strategies.
Monitoring & Follow-up
The study assessed 30-day all-cause mortality in relation to season and measured temperature extremes; it did not provide a monitoring protocol.
Risks
Extreme cold at admission and over the preceding 3-day mean was associated with higher adjusted 30-day mortality.
Admission season, extreme high ambient temperature, and day-to-day temperature fluctuation in the top 5th percentile were not associated with 30-day mortality in this cohort.
Patient & Prescribing Data
A retrospective cohort of 2,184 consecutive patients hospitalized with HFmrEF at University Medical Centre Mannheim, Germany, from January 2016 through December 2022.
HF pharmacotherapy prescriptions at discharge were comparable across seasons (all p > 0.10); the article provides no drug-specific prescribing or treatment-effect estimates.
Clinical Best Practices
The authors report findings from a single-centre retrospective cohort and a 30-day mortality outcome.
The study found no association between broad seasonal categories and mortality, but reported an association between extreme cold and mortality.
The reported temperature–mortality findings are adjusted associations; the study does not establish causation.
Moderate coffee consumption generally appeared safe for most adults, but randomized evidence suggested divergent effects on atrial fibrillation and premature ventricular contractions.
