Document Detail

Factors influencing survival and mode of death in severe chronic ischaemic cardiac failure.
MedLine Citation:
PMID:  3814447     Owner:  NLM     Status:  MEDLINE    
An evaluation of factors which may influence survival and mode of death was conducted over a three year period in a consecutive series of 50 patients with severe chronic ischaemic cardiac failure for more than three months. At the initial assessment all patients were already receiving intensive medical treatment. During follow up four patients successfully underwent cardiac surgery and medical treatment was modified in most patients, with four patients receiving antiarrhythmic drugs. Twenty six patients died: 17 suddenly within one hour of onset of symptoms and nine of progressive cardiac failure. The mortality by one year was 26% and by two years it was 62%. Comparison of those who survived with those who died within one year of follow up showed that a very low left ventricular ejection fraction, severe ventricular arrhythmias, the presence of gallop rhythm, and New York Heart Association class IV were the variables that predicted mortality. By two years left ventricular ejection fraction, ventricular arrhythmias, and pulmonary capillary wedge pressure were the variables that were significantly different in survivors and patients who died. No differences were found in any of the recorded variables between those who died suddenly and those who did not. Thus in patients with chronic ischaemic cardiac failure determination of the left ventricular ejection fraction and the severity of ventricular arrhythmia on the ambulatory electrocardiogram are the best ways to predict prognosis. The presence of gallop rhythm and New York Heart Association class IV status predict early death.
D R Glover; W A Littler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  57     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-04-16     Completed Date:  1987-04-16     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  125-32     Citation Subset:  AIM; IM    
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MeSH Terms
Chronic Disease
Coronary Disease / complications*,  physiopathology
Follow-Up Studies
Heart Failure / etiology,  mortality*,  physiopathology
Heart Ventricles / physiopathology
Middle Aged

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