Long-term survival in patients hospitalized with congestive heart failure: relation to preserved and reduced left ventricular systolic function.
OBJECTIVE
The purpose of this study was to evaluate the influence of left ventricular systolic function on the survival in a large consecutive cohort of patients hospitalized with congestive heart failure and to determine how left ventricular systolic function interacts with co-morbid conditions in terms of prognosis.


RESULTS
Analysis of survival data from 5491 patients admitted for new or worsening heart failure to 34 departments of cardiology or internal medicine in Denmark from 1993-1996 was carried out. A standardized echocardiogram was available for 95% of the patients, and left ventricular systolic function was estimated using wall motion index score. Follow-up time was 5-8 years. Patients with preserved systolic function were older, more frequently female, and had less evidence of ischemia than patients with systolic dysfunction. After 1 year, 24% of the patients had died. Low wall motion index was a potent independent predictor of death (risk ratio for one unit increase, 0.60 (0.56-0.64)), and was of greater prognostic significance in younger patients and patients with a history of myocardial ischemia. However, even in patients with preserved systolic function, mortality was high (1 year mortality, 19%).


CONCLUSIONS
In hospitalized heart failure patients, particularly in younger patients with ischemic heart disease, mortality risk is inversely related to left ventricular systolic function.
Department of Cardiology and Endocrinology E, Frederiksberg University Hospital, Frederiksberg, Denmark.
Finn
F
Gustafsson
Christian
C
Torp-Pedersen
Bente
B
Brendorp
Marie
M
Seibaek
Hans
H
Burchardt
Lars
L
Køber
D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006333:Heart Failure / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D011379:Prognosis; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality*