Heart failure with preserved left ventricular systolic function: a hospital cohort study. Issue 7 (14th June 2005)

• Record Type: Journal Article
• Authors: Berry, C; Hogg, K; Norrie, J; Stevenson, K; Brett, M; McMurray, J
• Is Part Of: Heart. Volume 91:Issue 7(2005)
• Page Start: 907
• Page End: 913
• Publication Date: 2005-06-14
• Subjects: ACE, angiotensin converting enzyme -- COPD, chronic obstructive pulmonary disease -- eGFR, estimated glomerular filtration rate -- HF, heart failure -- LVSF, left ventricular systolic function -- MDRD, modification of diet in renal disease; heart failure -- hospitalisation -- preserved systolic function -- reduced systolic function; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2004.041996
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To investigate how patients with heart failure with preserved left ventricular systolic function (LVSF) compare with patients with reduced LVSF. Design: Cohort study. Setting: Urban university hospital. Patients: 528 index emergency admissions with heart failure during the year 2000. Information on LVSF and follow up was available for 445 (84%) of these patients. Results: 130 (29%) patients had preserved LVSF (defined as an ejection fraction > 40%). The median follow up was 814 days (range 632–978 days). The average (SD) age was 72 (13) years. Women accounted for 62% and 45% of patients with preserved and reduced LVSF, respectively (p = 0.001). Patients with preserved LVSF (compared with those with reduced LVSF) had a higher prevalence of left ventricular hypertrophy (56% v 29%) and aortic valve disease (mean gradient > 20 mm Hg; 31% v 9%). Fewer patients with preserved LVSF received an angiotensin converting enzyme inhibitor (65% v 78%, p = 0.008) or spironolactone (12% v 21%, p = 0.027). Anaemia tended to occur more often in patients with preserved LVSF than in those with reduced LVSF (43% v 33% for women, p = 0.12; 59% v 49% for men, p = 0.22). There was a similarly high prevalence of significant renal dysfunction in both groups (estimated glomerular filtration rate < 60 ml/min/1.73 m 2 in 68% with preserved and 64% with reduced LVSF, p = 0.40). Mortality was similar in both groups (preserved versus reduced 51 (39%) v 132 (42%), p = 0.51). Compared with patients with reduced LVSF, patients with preserved LVSF tended to have a lower risk of death or hospital admission for heart failure (56 (42%) v 165 (53%), p = 0.072) but a similar rate of death or readmission for any reason. Conclusion: Patients with preserved LVSF had more co-morbid problems than those with reduced LVSF; however, prognosis was similar for both groups.