Clinical predictors of preserved left ventricular ejection fraction in decompensated heart failure.
BACKGROUND
Identification and clinical impact of preserved left ventricular ejection fraction (LVEF) on in-hospital outcomes in patients with acute decompensated heart failure (HF) remain poorly defined.


OBJECTIVE
To describe clinical predictors and in-hospital outcomes of acute decompensated HF patients and preserved LVEF, and to develop a clinically-based predictive rule based on data acquired on admission.


METHODS
Consecutive admissions for HF (n=721) at a tertiary care hospital were followed up to discharge or death. More than 80 clinical variables were evaluated to identify predictors of preserved LVEF upon admission.


RESULTS
Preserved LVEF (>50%) was identified in 224 (31%) hospitalizations. Clinical predictors of preserved LVEF were age > 70 years old (p=0.04), female gender (p<0.001), non-ischemic etiology (p<0.001), atrial fibrillation or flutter (p=0.001), anemia (p=0.001), pulse pressure > 45 mmHg (p<0.01) and absence of EKG conduction abnormalities (p<0.001). A clinical score based on these variables was accurate to predict preserved LVEF upon hospital admission (area under ROC curve of 0.76). No significant differences were observed on in-hospital mortality or clinical complications according to quintiles of LVEF.


CONCLUSIONS
Preserved LVEF is a prevalent and morbid condition among hospitalized HF patients. Simple clinical data obtained on admission might be useful for predicting preserved LVEF.
Goldraich
Livia
L
Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brazil.
Clausell
Nadine
N
Biolo
Andréia
A
Beck-da-Silva
Luís
L
Rohde
Luís Eduardo
LE
D000367:Age Factors; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000401:mortality*