Document Detail


Comparison of clinical features and outcomes of patients hospitalized with heart failure and normal ejection fraction (> or =55%) versus those with mildly reduced (40% to 55%) and moderately to severely reduced (<40%) fractions.
MedLine Citation:
PMID:  18394450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heart failure (HF) with normal ejection fraction (EF) is an increasingly common presentation of acute decompensated HF. Differences between patients with HF and truly normal EF and those with mildly impaired EF have not been described. The Acute Decompensated Heart Failure Registry (ADHERE) contains information on >100,000 HF hospitalizations and may provide insight into this distinction. The ADHERE database was used to investigate differences between patients hospitalized with HF and severely (<25%), moderately (25% to 40%), and mildly (40% to 55%) decreased EF and those with normal EF (> or =55%). The group with normal EF was 69% women with a mean age of 74 years (p <0.0001 vs all other groups). Coronary artery disease was less frequent in the normal EF group, and hypertension played a larger role. Patients with EF > or =55% had increased pulse pressure, suggesting a role for arterial stiffening. Treatment differed by EF. Creatinine increased > or =0.5 mg/dl more often in the group with HF and normal EF than in the group with HF and severely decreased EF. In-hospital mortality and length of stay in the intensive care unit varied inversely with EF; overall length of stay was similar. In conclusion, patients with HF and normal EF are more likely to be women, have a history of high pulse pressure hypertension, less coronary artery disease, and a lower risk of inpatient death but a higher likelihood of deterioration in renal function during hospitalization. These observations may be important considerations in the design of future clinical trials.
Authors:
Nancy K Sweitzer; Margarita Lopatin; Clyde W Yancy; Roger M Mills; Lynne W Stevenson
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2008-02-20
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-06-17     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1151-6     Citation Subset:  AIM; IM    
Affiliation:
University of Wisconsin, Madison, Wisconsin, USA. nks@medicine.wisc.edu
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Blood Pressure / physiology
Body Mass Index
Body Weight / physiology
Cardiotonic Agents / therapeutic use
Coronary Artery Disease / epidemiology
Creatinine / blood
Diuretics / therapeutic use
Drug Utilization
Female
Heart Failure / drug therapy,  epidemiology,  physiopathology*
Hospital Mortality
Hospitalization*
Humans
Hypertension / drug therapy,  epidemiology
Male
Outcome Assessment (Health Care)*
Registries
Renal Insufficiency / epidemiology
Severity of Illness Index*
Sex Distribution
Stroke Volume / physiology*
Grant Support
ID/Acronym/Agency:
AG01022 K23/AG/NIA NIH HHS; K23 AG001022-04/AG/NIA NIH HHS; K23 AG001022-05/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Diuretics; 60-27-5/Creatinine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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