[Clinical characteristics and medium-term prognosis of patients with heart failure and preserved systolic function. Do they differ in systolic dysfunction?].
OBJECTIVE
To assess the prevalence, clinical profile and medium-term prognosis in patients with heart failure and preserved systolic ventricular function compared to those with systolic dysfunction.


METHODS
153 patients were included, 62 with preserved systolic ventricular function (left ventricular ejection fraction > or = 45%) and 91 with impaired systolic ventricular function (left ventricular ejection fraction < 45%). The mean follow-up period was 25 10 months.


RESULTS
Mean age was similar (66 10 vs. 65 10; p = 0.54). There was a higher proportion of women among patients with preserved systolic function (53% vs. 28%; p < 0.01). Ischemic and idiopathic cardiomyopathy were the most common causes of heart failure in patients with systolic dysfunction, whereas valvular disease and hypertensive cardiopathy were the most common in patients with preserved systolic function. Angiotensin-converting enzyme inhibitors and beta-blockers were more often prescribed in patients with impaired systolic ventricular function (86% vs. 52%; p < 0.01 and 33% vs. 11%; p < 0.01, respectively). There were no differences between the groups in terms of mortality rate (37% vs. 29%), readmission rate for other causes (29% vs. 23%), readmission rate for heart failure (45% vs. 45%), cumulative survival (51% vs. 62%) and the likelihood of not being readmitted for heart failure (50% vs. 52%). In the multivariate analysis, left ventricular ejection fraction was not a predictor of death or readmission because of heart failure.


CONCLUSIONS
In a large proportion of patients with heart failure, systolic ventricular function is preserved. Despite the clinical differences between patients with preserved and impaired systolic ventricular function, the medium-term prognosis was similar in both groups.
Ojeda
Soledad
S
Servicio de Cardiología. Hospital Universitario Reina Sofía. Córdoba. España. sojeda@supercable.es
Anguita
Manuel
M
Muñoz
Juan F
JF
Rodríguez
Marcos T
MT
Mesa
Dolores
D
Franco
Manuel
M
Ureña
Isabel
I
Vallés
Federico
F
D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D016277:Ventricular Function, Left / Q000502:physiology
D002316:Cardiotonic Agents