title: Predictors of mortality in patients hospitalized for congestive heart failure with left ventricular ejection fraction ≥ 40.
abstract: BACKGROUND
  There are limited data regarding the predictors of mortality in patients with acute congestive heart failure (CHF) and left ventricular ejection fraction (LVEF) ≥ 40%.
  
  
  METHODS
  We evaluated clinical characteristics, mortality and prognostic factors in a sample of consecutive patients hospitalized for CHF with LVEF ≥ 40%. Multivariable Cox regression models were developed to predict mortality using baseline clinical characteristics and echocardiographic variables.
  
  
  RESULTS
  The study population consisted of 191 patients, mean age 70 ± 14.6 years (60% female) with average follow-up of 4.0 ± 2.8 years. Cumulative 5-year mortality was 58% in the entire population and it was 59% in men and 57% in women (p = 0.411). In multivariable analyses, predictors of mortality were the following: blood urea nitrogen (BUN) > 25 mg/dL (HR = 1.77; p = 0.002); absence of hypertension (HR = 1.58; p = 0.032), left ventricular end diastolic dimension (LVEDD) ≤ 4.1 cm (HR = 1.73; p = 0.011) and LVEF ≤ 45% (HR = 1.69; p = 0.027).
  
  
  CONCLUSIONS
  Patients hospitalized for heart failure with LVEF ≥ 40% have very high mortality. Absence of hypertension, elevated BUN and lower LVEF ≤ 45% indicate increased risk of short- and long-term mortality. Lower LVEDD is an independent predictor of mortality in heart failure patients with LVEF ≥ 40%.
authors.affiliation: Department of Cardiology at University of Rochester Medical Center, Rochester, New York, United States. Saadia_sherazi@urmc.rochester.edu.
authors.forename: Saadia
authors.initials: S
authors.lastname: Sherazi
authors.forename: Scott
authors.initials: S
authors.lastname: McNitt
authors.forename: Naila
authors.initials: N
authors.lastname: Choudhary
authors.forename: Abrar H
authors.initials: AH
authors.lastname: Shah
authors.forename: Mehmet K
authors.initials: MK
authors.lastname: Aktas
authors.forename: Adil
authors.initials: A
authors.lastname: Asgher
authors.forename: Karl Q
authors.initials: KQ
authors.lastname: Schwarz
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zareba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001806:Blood Urea Nitrogen; D016009:Chi-Square Distribution; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology*; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left