Congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction: clinical and prognostic implications.
OBJECTIVE
To characterise the prevalence, in-hospital complications, management, and long-term outcome of patients with congestive heart failure but preserved left ventricular systolic function after acute myocardial infarction.


METHODS
3166 consecutive patients screened for entry in the Bucindolol Evaluation in Acute Myocardial Infarction Trial with definite acute myocardial infarction and echocardiographic assessment of left ventricular systolic function were included between 1998 and 1999 in this prospective observational study. Main outcome measures were occurrences of in-hospital complications and all cause mortality.


RESULTS
Congestive heart failure was seen during hospitalisation in 1464 patients (46%), 717 patients had preserved left ventricular systolic function (wall motion index > or =1.3 corresponding to ejection fraction > or =0.40), and 732 patients had systolic dysfunction (wall motion index <1.3). One year mortality in patients with no heart failure, heart failure with preserved systolic function, and heart failure with systolic dysfunction were 6, 22 and 35%, P<0.0001. Unadjusted risk of death from all causes associated with heart failure and preserved systolic function was 3.3 (95% CI 2.8-4.0), and after adjustment for baseline characteristics and left ventricular systolic function in multivariate Cox proportional hazards analysis the risk was 2.1 (95% CI 1.7-2.6), P<0.0001.


CONCLUSIONS
Congestive heart failure is frequently present in patients with preserved left ventricular systolic function, and is associated with increased risk of in-hospital complications and death following acute myocardial infarction.
Møller
Jacob Eifer
JE
Department of Cardiology, Odense University Hospital, Odense, Denmark. jem@dadlnet.dk
Brendorp
Bente
B
Ottesen
Michael
M
Køber
Lars
L
Egstrup
Kenneth
K
Poulsen
Steen Hvitfelt
SH
Torp-Pedersen
Christian
C
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003718:Denmark / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality*