[Prognostic value of the left ventricular ejection fraction in patients with acute heart failure].
OBJECTIVE
The relation between left ventricular ejection fraction (LVEF) and prognosis in patients with heart failure is controversial. The aim of this study was to determine the relation of LVEF in long-term mortality and readmissions for acute heart failure in a non-selected population of patients admitted with acute heart failure (AHF).


METHODS
We included 507 patients admitted consecutively for AHF in a cardiology department of a single-centre. LVEF was assessed with transthoracic echocardiography during hospitalization. All-cause mortality and readmission for AHF were selected as primary and secondary endpoints, respectively. The independent association between LVEF and endpoints was assessed with traditional Cox regression analysis for all-cause mortality and Cox regression for competing risks for readmission for AHF.


RESULTS
47% of patients exhibited LVEF > or = 50%. During a median follow-up of one year, 151 (30%) deaths and 139 (27%) readmissions for AHF were observed. Mortality rates were higher in patients with LVEF < 50% (34 vs 25%; p = 0.028) and no differences were observed for readmissions for AHF (26 vs 29%, p = 0.510). In multivariate analysis, after adjustment for traditional risk factors, patients with LVEF < 50% did not show higher risk of mortality (hazard ratio [HR] = 1.08; 95% confidence interval [CI], 0.76-1.57; p = 0.645) or readmissions for AHF (HR = 1.00; 95% CI, 0.68-1.47; p = 1).


CONCLUSIONS
Patients with preserved LVEF constitute a substantial proportion of patients with AHF, exhibiting similar mortality and readmissions risks compared with patients with depressed LVEF.
Núñez
Julio
J
Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Universitat de València, Valencia, España. yulnunez@gmail.com
Mainar
Luis
L
Bodí
Vicent
V
Sanchis
Juan
J
Núñez
Eduardo
E
Miñana
Gema
G
Husser
Oliver
O
Bosch
María José
MJ
Chorro
Francisco J
FJ
Llàcer
Angel
A
D000208:Acute Disease; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011379:Prognosis; D013318:Stroke Volume; D016277:Ventricular Function, Left