Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome

BACKGROUND: Patients with heart failure (HF) have a poor prognosis. The proportion of patients with HF and preserved left ventricular function (LVF) is increasing. Long term prognosis of HF with preserved LVF may not be so benign. OBJECTIVES: To evaluate the long term clinical outcome of patients with HF and preserved LVF and predictors of outcome. METHODS: We prospectively evaluated 309 patients hospitalized with a definite clinical diagnosis of HF. Patients were followed for a mean of 6.5 years for clinical outcome. RESULTS: More than a third (36%) of the patients had preserved systolic LVF based on echocardiography. The long term survival rate in this group was poor and not significantly different from patients with reduced LVF (28% vs 23% respectively, P=0.2). The adjusted survival rate by Cox regression analysis was also not significantly different (hazard ratio 1.16, 95% confidence interval 0.87-1.55, P=0.31). The event free survival from death or heart failure re-hospitalization was also low in both groups and not significantly different between patients with preserved vs. reduced LVF (12% vs. 10% respectively, P=0.2). Predictors of mortality in patients with preserved LVF were age, functional capacity and serum urea levels. CONCLUSIONS: The long term clinical outcome of patients with heart failure and preserved LVF is poor and not significantly different from patients with reduced LVF.