Sudden Death Trajectories in HFpEF, HFmrEF - Summary - MDSpire
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Sudden Death Trajectories in HFpEF, HFmrEF

Clinical changes before death overlap across outcomes

  • By

  • Kathryn Wighton

  • March 31, 2026

  • 4 min

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Objective:

To evaluate longitudinal changes in functional status, health status, and biomarker levels preceding different modes of death in patients with heart failure with mildly reduced or preserved ejection fraction.

Approach:
    Key Findings:
    • In the 6 months preceding sudden death, NYHA class worsened slightly, symptom scores declined, and natriuretic peptide levels increased.
    • Patients who remained alive showed improvement across all measures.
    • Patients with heart failure-related death exhibited greater declines in functional status and higher NT-proBNP levels compared to those who died suddenly.
    • Sudden death accounts for 25% to 30% of deaths in heart failure with preserved ejection fraction.
    Interpretation:

    The observed trajectories of worsening functional status and increasing natriuretic peptide levels before sudden death are nonspecific, limiting their clinical actionability for preventive strategies.

    Limitations:
    • Post hoc design may introduce bias.
    • Potential misclassification of deaths.
    • Limited measurement of NT-proBNP levels.
    • Estimates provided at the population level rather than individual level.
    Conclusion:

    These trajectories may indicate heightened vulnerability to death, aiding in identifying patients at increased overall risk rather than guiding specific preventive strategies for sudden death.

    Sources:

Original Source(s)

Sudden Death Trajectories in HFpEF, HFmrEF

  • by Kathryn Wighton

  • March 31, 2026

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