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[Differences in clinical profile and outcome in patients with decompensated heart failure and systolic dysfunction or preserved systolic function].
Rev Esp Cardiol. 2004 Jan; 57(1):45-52.RE

Abstract

OBJECTIVES

To compare the clinical characteristics and short- and long-term prognosis for chronic heart failure with left ventricular systolic dysfunction or preserved systolic function.

PATIENTS AND METHOD

Three-hundred twenty-eight consecutive patients with decompensated chronic heart failure were studied prospectively. Depending on ejection fraction, participants were classified as having systolic dysfunction (group 1, ejection fraction < or = 40%,) or preserved systolic function (group 2, ejection fraction >40%).

RESULTS

Systolic dysfunction was detected in 192 patients (58.5%) and preserved systolic function in 41.5%. Mean age was 62.7 (12.5 years) in group 1 and 65.2 (16.2 years) in group 2 (P=.03), with a male prevalence of 73.3% and 49.3%, respectively (P<.001). Ischemic cardiomyopathy was more frequent in group 1 (44.8% vs 25%; P<.001). Physical examination and electrocardiogram findings were similar in both groups, except for a higher proportion of patients in group 1 with a heart third sound (43.2% vs 25%; P=.001) and left bundle branch block (40.6% vs 15.4%; P<.001) and abnomal Q waves (31.3% vs 20.6%; P=.04). In-hospital mortality was similar in patients with systolic dysfunction and preserved systolic function (2.9% vs 1%; P=NS). Twenty-four-month cumulative survival was 61% for patients with systolic dysfunction and 76% for patients with preserved systolic function (log rank test P=NS). In the Cox proportional hazards model, which included age, sex, functional class, hepatomegaly, peripheral hypoperfusion, BUN, sodium level, ejection fraction > 40%, and biventricular heart failure, preserved systolic function was not associated with late mortality. The variables that were independent predictors of late mortality were peripheral hypoperfusion (OR = 3.7; P<.0001), low sodium level (OR=0.9; P=.009) and male sex (OR=1.9; P=.041).

CONCLUSIONS

Decompensated chronic heart failure with preserved systolic function was more frequent in women and older patients. Patients with preserved systolic function had a lower prevalence of coronary heart disease. However, these differences had no impact on the short- and long-term prognosis.

Authors+Show Affiliations

Instituto de Cardiología Juana Francisca Cabral. Corrientes. Argentina. macinucic@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

spa

PubMed ID

14746717

Citation

Macín, Stella M., et al. "[Differences in Clinical Profile and Outcome in Patients With Decompensated Heart Failure and Systolic Dysfunction or Preserved Systolic Function]." Revista Espanola De Cardiologia, vol. 57, no. 1, 2004, pp. 45-52.
Macín SM, Perna ER, Címbaro Canella JP, et al. [Differences in clinical profile and outcome in patients with decompensated heart failure and systolic dysfunction or preserved systolic function]. Rev Esp Cardiol. 2004;57(1):45-52.
Macín, S. M., Perna, E. R., Címbaro Canella, J. P., Alvarenga, P., Pantich, R., Ríos, N., Farías, E. F., & Badaracco, J. R. (2004). [Differences in clinical profile and outcome in patients with decompensated heart failure and systolic dysfunction or preserved systolic function]. Revista Espanola De Cardiologia, 57(1), 45-52.
Macín SM, et al. [Differences in Clinical Profile and Outcome in Patients With Decompensated Heart Failure and Systolic Dysfunction or Preserved Systolic Function]. Rev Esp Cardiol. 2004;57(1):45-52. PubMed PMID: 14746717.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Differences in clinical profile and outcome in patients with decompensated heart failure and systolic dysfunction or preserved systolic function]. AU - Macín,Stella M, AU - Perna,Eduardo R, AU - Címbaro Canella,Juan P, AU - Alvarenga,Pablo, AU - Pantich,Rolando, AU - Ríos,Nelson, AU - Farías,Eduardo F, AU - Badaracco,Jorge R, PY - 2004/1/30/pubmed PY - 2004/4/17/medline PY - 2004/1/30/entrez SP - 45 EP - 52 JF - Revista espanola de cardiologia JO - Rev Esp Cardiol VL - 57 IS - 1 N2 - OBJECTIVES: To compare the clinical characteristics and short- and long-term prognosis for chronic heart failure with left ventricular systolic dysfunction or preserved systolic function. PATIENTS AND METHOD: Three-hundred twenty-eight consecutive patients with decompensated chronic heart failure were studied prospectively. Depending on ejection fraction, participants were classified as having systolic dysfunction (group 1, ejection fraction < or = 40%,) or preserved systolic function (group 2, ejection fraction >40%). RESULTS: Systolic dysfunction was detected in 192 patients (58.5%) and preserved systolic function in 41.5%. Mean age was 62.7 (12.5 years) in group 1 and 65.2 (16.2 years) in group 2 (P=.03), with a male prevalence of 73.3% and 49.3%, respectively (P<.001). Ischemic cardiomyopathy was more frequent in group 1 (44.8% vs 25%; P<.001). Physical examination and electrocardiogram findings were similar in both groups, except for a higher proportion of patients in group 1 with a heart third sound (43.2% vs 25%; P=.001) and left bundle branch block (40.6% vs 15.4%; P<.001) and abnomal Q waves (31.3% vs 20.6%; P=.04). In-hospital mortality was similar in patients with systolic dysfunction and preserved systolic function (2.9% vs 1%; P=NS). Twenty-four-month cumulative survival was 61% for patients with systolic dysfunction and 76% for patients with preserved systolic function (log rank test P=NS). In the Cox proportional hazards model, which included age, sex, functional class, hepatomegaly, peripheral hypoperfusion, BUN, sodium level, ejection fraction > 40%, and biventricular heart failure, preserved systolic function was not associated with late mortality. The variables that were independent predictors of late mortality were peripheral hypoperfusion (OR = 3.7; P<.0001), low sodium level (OR=0.9; P=.009) and male sex (OR=1.9; P=.041). CONCLUSIONS: Decompensated chronic heart failure with preserved systolic function was more frequent in women and older patients. Patients with preserved systolic function had a lower prevalence of coronary heart disease. However, these differences had no impact on the short- and long-term prognosis. SN - 0300-8932 UR - https://www.unboundmedicine.com/medline/citation/14746717/[Differences_in_clinical_profile_and_outcome_in_patients_with_decompensated_heart_failure_and_systolic_dysfunction_or_preserved_systolic_function]_ L2 - http://www.revespcardiol.org/en/linksolver/ft/ivp/0300-8932/57/45 DB - PRIME DP - Unbound Medicine ER -