title: Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction: results of the New York Heart Failure Registry.
abstract: OBJECTIVE
  We conducted a prospective multicenter registry in a large metropolitan area to define the clinical characteristics, hospital course, treatment, and factors precipitating decompensation in patients hospitalized for heart failure with a normal ejection fraction (HFNEF).
  
  
  BACKGROUND
  The clinical profile of patients hospitalized for HFNEF has been characterized by retrospective analyses of hospital records and state data banks, with few prospective single-center studies.
  
  
  METHODS
  Patients hospitalized for heart failure (HF) at 24 medical centers in the New York metropolitan area and found to have a left ventricular (LV) ejection fraction of > or 50% within seven days of admission were included in this registry. Patient demographics, signs and symptoms of HF, coexisting and exacerbating cardiovascular and medical conditions, treatment, laboratory tests, procedures, and hospital outcomes data were collected. Analysis by gender and race was prespecified.
  
  
  RESULTS
  Of 619 patients, 73% were women, who were on average four years older than men (72.8 +/- 14.1 years vs. 68.6 +/- 13.8 years, p < 0.001). Black non-Hispanic patients comprised 30% of the study population. They were eight years younger than other patients (66.0 +/- 14.2 years vs. 74 +/- 13.5 years p < 0.001). Co-morbid conditions and their prevalence were: hypertension, 78%; increased LV mass, 82%; diabetes, 46%; and obesity, 46%. Before clinical decompensation that precipitated hospitalization, 86% of patients had chronic symptoms compatible with New York Heart Association functional classes II to IV. Factors precipitating clinical decompensation were identified in 53% of patients. In-hospital mortality was 4.2%.
  
  
  CONCLUSIONS
  Patients hospitalized for HFNEF are most often chronically incapacitated elderly women with a history of hypertension and increased LV mass. Reasons for clinical decompensation are identified in only one-half of patients.
authors.affiliation: Saint Vincent Catholic Medical Centers, New York, New York, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Klapholz
authors.forename: Matthew
authors.initials: M
authors.lastname: Maurer
authors.forename: April M
authors.initials: AM
authors.lastname: Lowe
authors.forename: Frank
authors.initials: F
authors.lastname: Messineo
authors.forename: Jay S
authors.initials: JS
authors.lastname: Meisner
authors.forename: Judith
authors.initials: J
authors.lastname: Mitchell
authors.forename: Jill
authors.initials: J
authors.lastname: Kalman
authors.forename: Robert A
authors.initials: RA
authors.lastname: Phillips
authors.forename: Richard
authors.initials: R
authors.lastname: Steingart
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Brown
authors.forename: Robert
authors.initials: R
authors.lastname: Berkowitz
authors.forename: Robert
authors.initials: R
authors.lastname: Moskowitz
authors.forename: Anita
authors.initials: A
authors.lastname: Soni
authors.forename: Donna
authors.initials: D
authors.lastname: Mancini
authors.forename: Rachel
authors.initials: R
authors.lastname: Bijou
authors.forename: Khashayar
authors.initials: K
authors.lastname: Sehhat
authors.forename: Nikita
authors.initials: N
authors.lastname: Varshneya
authors.forename: Marrick
authors.initials: M
authors.lastname: Kukin
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Katz
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Sleeper
authors.forename: Thierry H
authors.initials: TH
authors.lastname: Le Jemtel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004232:Diuretics / Q000627:therapeutic use; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D004232:Diuretics