title: Outcomes and prognostic factors of systolic as compared with diastolic heart failure in urban America.
abstract: We sought to describe a large heart failure (HF) population with respect to systolic and diastolic abnormalities in terms of demographics, echocardiographic parameters, and survival. Using data abstracted from the Resource Utilization Among Congestive Heart Failure (REACH) study, a targeted subpopulation of 3471 patients had electrocardiographic, echocardiographic, and clinical data taken from automated sources during the first year of diagnosis. Among the HF population, 1811 (52.2%) had diastolic HF. Prevalence of diastolic HF trended with age, from 46.4% in those less than 45 years to 58.7% in those 85 years or older (p=0.001 for trend). Patients with diastolic HF had a higher mean ejection fraction (55.7% vs. 28.0%), lower left ventricular end-systolic diameter (3.11 vs. 4.74 cm), and lower left atrium:aortic outlet ratio (1.28 vs. 1.38) (p=0.001 for each comparison). Annualized age, sex, and race-adjusted mortality were 11.2% and 13.0% for those with diastolic and systolic HF, respectively (p=0.001). In a large, racially mixed, urban HF population, those with diastolic HF predominate and enjoy better-adjusted survival than counterparts with systolic HF.
authors.affiliation: Division of Cardiology, William Beaumont Hospital, 4949 Coolidge Highway, Royal Oak, MI 48073, USA. pmc975@yahoo.com
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
authors.forename: Akshay K
authors.initials: AK
authors.lastname: Khandelwal
authors.forename: John E
authors.initials: JE
authors.lastname: McKinnon
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Shenkman
authors.forename: Vijayamalini
authors.initials: V
authors.lastname: Pampati
authors.forename: David
authors.initials: D
authors.lastname: Nori
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Sullivan
authors.forename: Keisha R
authors.initials: KR
authors.lastname: Sandberg
authors.forename: Scott
authors.initials: S
authors.lastname: Kaatz
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003710:Demography; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D016019:Survival Analysis; D013599:Systole / Q000502:physiology; D014481:United States / Q000453:epidemiology