heart failure and preserved left ventricular function long term clinical outcome心脏衰竭和左心室功能保存长期的临床结果.pdfVIP

Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome Israel Gotsman*, Donna Zwas, Chaim Lotan, Andre Keren Heart Institute, Hadassah University Hospital, Jerusalem, Israel Abstract Background: Patients with heart failure (HF) have a poor prognosis. The proportion of patients with HF and preserved left ventricular function (LVF) is increasing. Long term prognosis of HF with preserved LVF may not be so benign. Objectives: To evaluate the long term clinical outcome of patients with HF and preserved LVF and predictors of outcome. Methods: We prospectively evaluated 309 patients hospitalized with a definite clinical diagnosis of HF. Patients were followed for a mean of 6.5 years for clinical outcome. Results: More than a third (36%) of the patients had preserved systolic LVF based on echocardiography. The long term survival rate in this group was poor and not significantly different from patients with reduced LVF (28% vs 23% respectively, P = 0.2). The adjusted survival rate by Cox regression analysis was also not significantly different (hazard ratio 1.16, 95% confidence interval 0.87–1.55, P = 0.31). The event free survival from death or heart failure re-hospitalization was also low in both groups and not significantly different between patients with preserved vs. reduced LVF (12% vs. 10% respectively, P = 0.2). Predictors of mortality in patients with preserved LVF were age, functional capacity and serum urea levels. Conclusions: The long term clinical outcome of patients with heart failure and preserved LVF is poor and not significantly different from patients with reduced LVF. Citation: Gotsman I, Zwas D, Lotan C, Keren A (2012) Heart Failure and Preserved Left Ventricular Function: Long Term Clinical Outcome. PLoS ONE 7(7): e41022. doi:10.1371/journal.pone.0041022 Editor: German Malaga, Universidad