Related Experiment Video
Updated: Aug 19, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Managed care patients with heart failure: spectrum of ventricular dysfunction and predictors of medication
Carla A Sueta1, Alain G Bertoni, Mark W Massing
1Medical Review of North Carolina, Cary, North Carolina 27511-8598, USA.
Insights
Heart failure (HF) treatment varied by ventricular function documentation. Preserved function was common, but documenting dysfunction improved care quality for heart failure patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacotherapy
Background:
- Heart failure (HF) is a prevalent clinical syndrome with significant morbidity and mortality.
- Understanding ventricular dysfunction is crucial for effective HF management.
- Optimizing medication prescription is key to improving patient outcomes.
Purpose of the Study:
- To investigate the spectrum of ventricular dysfunction in managed care patients with HF.
- To identify predictors of angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, and spironolactone prescription.
- To assess the impact of HF type documentation on treatment quality.
Main Methods:
- Retrospective analysis of 1613 managed care patients diagnosed with HF in 2000.
- Logistic regression modeling to identify predictors of medication use.
- Categorization of patients based on documented systolic function: preserved, mild, moderate-severe, or inadequate.
Main Results:
- 37% of patients had preserved systolic function; 18% had inadequate documentation.
- Patients with documented systolic dysfunction received more aggressive treatment.
- Coronary artery disease, hypertension, and diabetes predicted increased use of ACE inhibitors and beta-blockers.
- Older age was associated with lower utilization of beta-blockers and spironolactone.
Conclusions:
- Preserved left ventricular function is common in HF patients.
- Improved documentation of HF type and systolic dysfunction is linked to better care quality.
- Further research on HF with preserved systolic function and interventions to enhance documentation are needed.
Background:
Heart failure (HF) is a common clinical syndrome resulting in high morbidity and mortality. We examined the spectrum of ventricular dysfunction, and investigated the predictors of angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, and spironolactone prescription in 1613 managed care patients with HF.
Methods And Results:
The diagnosis of HF was made by a HF discharge diagnosis or at least 3 physician encounters with a HF diagnosis during 2000. Logistic regression was used to identify predictors of medication prescription. Preserved systolic function was documented in 37%, moderate-severe systolic dysfunction in 31%, mild systolic in 14%, and 18% had inadequate documentation. The mean age was 69 years, 58% were women, 24% African American, and 60% were Medicare patients. Patients without HF type documented were the least aggressively treated. Coronary artery disease, hypertension, and diabetes predicted increased utilization of ACE inhibitor and beta-blocker therapies. History of nephropathy was associated with less ACE inhibitor prescription. Advancing age predicted less utilization of beta-blockers and spironolactone. Neither ethnicity nor gender influenced medication prescription.
Conclusion:
Preserved left ventricular function was common. Documentation of significant systolic dysfunction was associated with improved quality of care. Interventions to encourage documentation of HF type and further study of HF with preserved systolic function are warranted.
Related Concept Videos
01:30Heart Failure V: Medical Management
01:29Cardiomyopathy V: Interprofessional Care
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:22Heart Failure VI: Adjunct Therapies
01:30Heart Failure VII: Nursing Interventions