title: Heart failure with preserved versus reduced left ventricular systolic function: a prospective cohort of Shinken Database 2004-2005.
abstract: BACKGROUND
  Several hospital-based investigations have reported that a high proportion of patients with heart failure (HF) have preserved left ventricular ejection fraction (LVEF). The purpose of this study was to determine the prevalence, prognosis, and predictors for mortality of Japanese HF patients with preserved versus reduced LVEF in a prospective cohort fashion.
  
  
  RESULTS
  Our hospital-based database including inpatients and also outpatients was used for analysis. Out of 4255 new patients, 597 patients (male/female 414/183, age 65.1+/-12.9 years) were diagnosed as having symptomatic HF at the initial visit. Among 589 HF patients undergoing echocardiography, 398 (67.6%) showed a preserved LVEF (>50%) and 191 (32.4%) had a reduced LVEF (< or =50%). Patients with preserved LVEF were older (p=0.004) and more likely to be female (p=0.002). During follow-up of an average 539 days, 34 cardiovascular deaths occurred, and patients with preserved LVEF showed a better prognosis than those with reduced LVEF (3.2% vs. 7.4% per year, p=0.0097). Multivariate Cox hazards analysis identified LVEF as an independent predictor in all HF patients. Also, separated group analysis showed that presence of chronic kidney disease was independently associated with poor prognosis irrespective of HF types.
  
  
  CONCLUSIONS
  This prospective cohort study identified prevalence and prognosis of HF in Japanese in- and outpatients, where patients with preserved LVEF showed a better prognosis than those with reduced LVEF.
authors.affiliation: The Cardiovascular Institute, Tokyo, Japan. ayumi-go@cvi.or.jp
authors.forename: Ayumi
authors.initials: A
authors.lastname: Goda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Tokuhisa
authors.initials: T
authors.lastname: Uejima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Junji
authors.initials: J
authors.lastname: Yajima
authors.forename: Akira
authors.initials: A
authors.lastname: Koike
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagashima
authors.forename: Hajime
authors.initials: H
authors.lastname: Kirigaya
authors.forename: Koichi
authors.initials: K
authors.lastname: Sagara
authors.forename: Ken
authors.initials: K
authors.lastname: Ogasawara
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sawada
authors.forename: Tadanori
authors.initials: T
authors.lastname: Aizawa
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology