title: Comparisons of prognostic factors between young and elderly patients with chronic heart failure.
abstract: OBJECTIVE
  The purpose in the present study was to compare prognostic risk factors between older and younger chronic heart failure (CHF) patients.
  
  
  METHODS
  We examined 598 consecutive CHF patients (476 men and 122 women, mean age 61.4 ± 14.3 years) who underwent cardiopulmonary exercise testing, echocardiography and blood examination. We divided the 598 patients into two groups: the elderly group (age ≥75 years, n = 123) and the young group (age <75, n = 475). We compared blood testing data, exercise capacity, cardiac function and prognosis between the two groups. Patients were followed up (median 782 days) to register cardiac deaths or rehospitalization as a result of worsening heart failure.
  
  
  RESULTS
  Patients in the elderly group were associated with higher frequencies of atrial fibrillation and diuretic use than those in the young group. Patients in the elderly group had lower hemoglobin concentration, more impaired renal function, higher plasma B-type natriuretic peptide (BNP) levels, smaller left ventricular volume, longer deceleration time of early mitral wave and lower exercise capacity than those in the young group. There were 199 cardiac events during follow-up periods. As expected, Kaplan-Meier analysis showed that patients in the elderly group had higher cardiac event rates than those in the young group. In the young group, multivariable Cox hazard analysis showed that hemoglobin concentration, log BNP and peak VO(2) were independent predictors related to cardiac events. In contrast, in the elderly group, estimated glomerular filtration rate, atrial fibrillation and peak VO(2) were independent factors to predict adverse clinical outcomes.
  
  
  CONCLUSIONS
  Prognostic factors were different between the elderly and young patients in CHF.
authors.affiliation: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kanno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Akiomi
authors.initials: A
authors.lastname: Yoshihisa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Yamaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kunii
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakazato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Saitoh
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
mesh_terms: D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D011379:Prognosis; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis
chemical_list: D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; age; chronic heart failure; clinical outcome