title: Late mortality and determinants in patients with heart failure and preserved systolic left ventricular function: the Israel Nationwide Heart Failure Survey.
abstract: BACKGROUND
  Heart failure with preserved systolic left ventricular function is a major cause of cardiac disability.
  
  
  OBJECTIVE
  To examine the prevalence, characteristics and late clinical outcome of patients hospitalized with HF-PSF on a nationwide basis in Israel.
  
  
  METHODS
  The Israel nationwide HF survey examined prospectively 4102 consecutive HF patients admitted to 93 internal medicine and 24 cardiology departments in all 25 public hospitals in the country. Echocardiographic LV function measurements were available in 2845 patients (69%). The present report relates to the 1364 patients who had HF-PSF (LV ejection fraction > or = 40%).
  
  
  RESULTS
  Mortality of HF-PSF patients was high (in-hospital 3.5%, 6 months 14.2%, 12 months 22.0%), but lower than in patients with reduced systolic function (all P < 0.01). Mortality was higher in patients with HF as the primary hospitalization diagnosis (16.0% vs. 12.5% at 6 months, P = 0.07 and 26.2% vs. 18.0% at 12 months, P = 0.0002). Patients with HF-PSF who died were older (78 +/- 10 vs. 71 +/- 12 years, P < 0.001), more often female (P = 0.05) and had atrial fibrillation more frequently (44% vs. 33%, P < 0.01). There was also a relationship between mortality and pharmacotherapy: after adjustment for age and co-morbid conditions, mortality was lower in patients treated with angiotensin-converting enzyme inhibitors (P = 0.0003) and angiotensin receptor blockers (P = 0.002) and higher in those receiving digoxin (P = 0.003) and diuretic therapy (P = 0.009).
  
  
  CONCLUSIONS
  This nationwide survey highlights the very high late mortality rates in patients hospitalized for HF without a decrease in systolic function. The findings mandate a focus on better evidence-based treatment strategies to improve outcome in HF-PSF patients.
authors.affiliation: Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel. lewis@tx.technion.ac.il
authors.forename: Basil S
authors.initials: BS
authors.lastname: Lewis
authors.forename: Avraham
authors.initials: A
authors.lastname: Shotan
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Shlomo
authors.initials: S
authors.lastname: Behar
authors.forename: David A
authors.initials: DA
authors.lastname: Halon
authors.forename: Valentina
authors.initials: V
authors.lastname: Boyko
authors.forename: Jonathan
authors.initials: J
authors.lastname: Leor
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.forename: Reuven
authors.initials: R
authors.lastname: Zimlichman
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
authors.forename: Moshe
authors.initials: M
authors.lastname: Mittelman
authors.forename: Abraham
authors.initials: A
authors.lastname: Caspi
authors.forename: Moshe
authors.initials: M
authors.lastname: Garty
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007297:Inpatients; D007557:Israel / Q000453:epidemiology; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D011159:Population Surveillance; D011446:Prospective Studies; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*