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Identification of high-risk chronic heart failure patients in clinical practice: role of changes in left ventricular

Mariantonietta Cicoira1, Andrea Rossi, Andrea Chiampan

  • 1Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy. mariantonietta.cicoira@univr.it

Clinical Cardiology
|June 19, 2012
PubMed

Insights

In stable chronic heart failure (CHF), left ventricular (LV) function improves in 24% of patients. Worsening LV systolic function significantly increases mortality risk, regardless of other severity markers.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Echocardiography

Background:

  • Left ventricular (LV) dysfunction and remodeling are central to chronic heart failure (CHF) progression.
  • Understanding LV changes is crucial for managing CHF patients.

Purpose of the Study:

  • To track LV dysfunction and function changes in stable CHF patients on optimal therapy.
  • To identify predictors of LV changes and their prognostic impact on mortality.

Main Methods:

  • 318 CHF outpatients underwent serial echocardiography (baseline and 1 year).
  • Patients were followed for at least 12 months, with all-cause mortality as the primary endpoint.
  • Cox analysis assessed the prognostic impact of LV function changes.

Main Results:

  • Mean LV ejection fraction (LVEF) improved slightly from 33% to 36%.
  • 24% of patients showed LVEF improvement (>5 points), 58% remained stable, and 17% worsened (>5 points).
  • Worsening LV function (group 3) was linked to a 4-fold higher mortality risk compared to improved function (group 1).

Conclusions:

  • LV function improves in a subset (24%) of stable CHF outpatients.
  • A decline in LV systolic function independently predicts increased mortality risk in CHF.
  • Serial echocardiography is vital for assessing prognosis in CHF management.
Abstract

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