Related Experiment Videos
[Hospitalized congestive heart failure patients with preserved versus abnormal left ventricular systolic function]
Manuel Martínez-Sellés1, José A García Robles, Luis Prieto
1Servicio de Cardiología. Hospital Universitario Gregorio Marañón. Madrid. Spain. mmselles@navegalia.com
Insights
Patients with heart failure and systolic dysfunction have distinct clinical profiles and higher mortality. Key predictors include myocardial infarction, bundle-branch block, male sex, and smoking, influencing treatment and outcomes.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Heart failure (HF) is a complex syndrome with varying underlying pathophysiology.
- Left ventricular dysfunction (LVD) significantly impacts HF patient characteristics and outcomes.
- Understanding differences between HF with LVD and HF with normal systolic function is crucial for effective management.
Purpose of the Study:
- To compare the clinical characteristics of hospitalized patients with congestive heart failure (CHF) and left ventricular dysfunction (LVD) versus those with normal systolic function.
- To identify clinical variables predicting the presence of systolic dysfunction in HF patients.
- To analyze differences in hospitalizations, discharge medications, and mortality between these groups.
Main Methods:
- Retrospective review of clinical records for all admissions with a heart failure diagnostic code over a one-year period.
- Exclusion of patients not meeting diagnostic criteria.
- Analysis of echocardiographic data to determine the presence and severity of ventricular dysfunction.
Main Results:
- Of 1,358 confirmed HF admissions, 706 patients underwent echocardiography, with 381 (54%) exhibiting ventricular dysfunction.
- Ventricular dysfunction was strongly associated with prior myocardial infarction (OR=5.8) and left bundle-branch block (OR=5.0).
- Patients with LVD experienced higher mortality (OR=2.9) and received more vasodilators, aspirin, and nitrates upon discharge.
Conclusions:
- Patients admitted with heart failure and systolic dysfunction present with a different clinical profile compared to those with normal ejection fraction.
- Seven clinical variables were identified as predictors of systolic dysfunction.
- Systolic dysfunction in heart failure patients is linked to increased hospital mortality and distinct discharge medication patterns.
Objectives:
To compare the clinical characteristics of hospitalized patients with congestive heart failure and left ventricular dysfunction versus normal systolic function.
Methods:
Clinical records of all admissions with a heart failure diagnostic code over a one-year period were reviewed retrospectively. Of 1,953 admissions, 595 were excluded because they did not fulfill diagnostic criteria.
Results:
A total of 1,069 patients had 1,358 admissions with confirmed heart failure (1.27 admissions/patient). Of them, 706 patients (66%) had an echocardiographic study and 381 (54%) had ventricular dysfunction. Ventricular dysfunction was associated with previous myocardial infarction (OR = 5.8), left bundle-branch block (OR = 5.0), male sex (OR = 2.0), and smoking (OR = 1.8). Meanwhile, a negative association existed with age (OR = 0.97), previous valve surgery (OR = 0.46) and atrial fibrillation (OR = 0.49). Patients with ventricular dysfunction had more hospitalizations in the cardiology department and received more vasodilators, aspirin, and nitrates on discharge. The prescription of angiotensin converting enzyme inhibitors prescription to patients with ventricular dysfunction increased with the severity of ventricular dysfunction and was more frequent in patients admitted to the cardiology department. Systolic dysfunction increased hospital mortality (OR = 2.9).
Conclusions:
Patients admitted with heart failure and systolic dysfunction had a different clinical profile than patients with a normal ejection fraction. Seven clinical variables predicted the presence of systolic dysfunction. Patients with ventricular dysfunction had more hospital mortality and were prescribed vasodilators, aspirin, and nitrates more often on discharge.