Document Detail


Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure.
MedLine Citation:
PMID:  20048206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies of the effect of right ventricular ejection fraction (RVEF) on outcomes in heart failure (HF) are limited by small sample size and short follow-up.
METHODS AND RESULTS: We examined the effect of baseline RVEF on outcomes in 2008 Beta-Blocker Evaluation of Survival Trial (BEST) participants with HF and left ventricular ejection fraction <or=35% during 24 months of mean follow-up. RVEF, estimated by gated-equilibrium radionuclide ventriculography, was used to categorize patients into 4 RVEF groups: >or=40% (n=733), 30% to 39% (n=531), 20% to 29% (n=473), and <20% (n=271). Unadjusted rates for all-cause mortality in patients with RVEF >or=40%, 30% to 39%, 20% to 29%, and <20% were 27%, 32%, 35%, and 47%, respectively. When compared with patients with RVEF >or=40%, unadjusted hazard ratios and 95% confidence intervals for all-cause mortality for those with RVEF 30% to 39%, 20% to 29%, and <20% were 1.19 (0.97 to 1.46; P=0.087), 1.45 (1.17 to 1.78; P=0.001), and 1.98 (1.59 to 2.47; P<0.0001), respectively. Respective multivariable-adjusted hazard ratios (95% confidence intervals) for all-cause mortality associated with RVEF 30% to 39%, 20% to 29%, and <20% were 1.07 (0.87 to 1.32; P=0.518), 1.12 (0.89 to 1.40; P=0.328), and 1.32 (1.02 to 1.71; P=0.034), respectively. Adjusted hazard ratios (95% confidence intervals) for other outcomes associated with RVEF <20% (compared with >or=40%) were as follows: cardiovascular mortality, 1.33 (1.01 to 1.76; P=0.041); HF mortality, 1.61 (1.03 to 2.52; P=0.037); sudden cardiac death, 1.29 (0.87 to 1.91; P=0.212); all-cause hospitalization, 1.21 (1.00 to 1.47; P=0.056); and HF hospitalization, 1.39 (1.10 to 1.77; P=0.007).
CONCLUSIONS: Baseline RVEF <20% is a significant independent predictor of mortality and HF hospitalization in systolic HF.
Authors:
Philippe Meyer; Gerasimos S Filippatos; Mustafa I Ahmed; Ami E Iskandrian; Vera Bittner; Gilbert J Perry; Michel White; Inmaculada B Aban; Marjan Mujib; Louis J Dell'Italia; Ali Ahmed
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-01-04
Journal Detail:
Title:  Circulation     Volume:  121     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-03-18     Revised Date:  2011-07-20    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  252-8     Citation Subset:  AIM; IM    
Affiliation:
Montreal Heart Institute, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Chronic Disease
Death, Sudden, Cardiac
Female
Heart Failure, Systolic / mortality,  physiopathology*
Hospitalization
Humans
Male
Middle Aged
Predictive Value of Tests*
Stroke Volume*
Survival Rate
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 HL085561-04/HL/NHLBI NIH HHS; R01 HL097047-01/HL/NHLBI NIH HHS; R01-HL085561/HL/NHLBI NIH HHS; R01-HL097047/HL/NHLBI NIH HHS
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