PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
July 19, 2012PLoS ONE20 citationsOpen Access

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

IGIsrael GotsmanDZDonna R. ZwasCLChaim Lotan

Key Result

Preserved left ventricular function in heart failure patients was associated with a poor long-term survival rate that was not significantly different from patients with reduced function (HR 1.16).

Study Design

Type

Cohort (n=309)

Multicenter

No

Structured PICO

Does preserved left ventricular function compared to reduced left ventricular function improve long-term survival in patients hospitalized with heart failure?

P
Population
309 consecutive patients hospitalized with a definite clinical diagnosis of heart failure, mean age 73, 53% male.
I
Intervention
Preserved left ventricular function (LVF)
C
Comparator
Reduced left ventricular function (LVF)
O
Outcome
Long-term survival and event-free survival from death or heart failure re-hospitalizationhard clinical

The long-term clinical outcome of patients with heart failure and preserved left ventricular function is poor and not significantly different from those with reduced left ventricular function.

Main Result

Effect estimate: HR 1.16 (95% CI 0.87-1.55)

Absolute Event Rate: 28% vs 23%

p-value: p=0.31

Limitations

  • Delineated patients based on qualitative echocardiographical data rather than left ventricular ejection fraction
  • Included patients based on clinical grounds rather than an objective test for heart failure
  • Only recruited patients hospitalized in internal medicine wards
  • Did not exclude patients with valve disease
  • Significant differences in background diseases between the two groups
  • Classification of preserved vs reduced LVF based on qualitative echocardiographical data and not on LV ejection fraction
  • Included patients based on clinical grounds and not on an objective test for HF
  • Only patients hospitalized in internal medicine wards were recruited

Abstract

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.

Ask AI
Helpful
Bookmark
Share
View Full Paper

Cite This Study

Gotsman et al. (2012) conducted a cohort in Heart failure (n=309). Preserved left ventricular function vs. Reduced left ventricular function was evaluated on Long-term survival rate (HR 1.16, 95% CI 0.87-1.55, p=0.31). Preserved left ventricular function in heart failure patients was associated with a poor long-term survival rate that was not significantly different from patients with reduced function (HR 1.16).

synapsesocial.com/papers/6a0f025baa1655e5fb23219ahttps://doi.org/10.1371/journal.pone.0041022
Ask AI
Helpful
Bookmark
Share
View Full Paper