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Patient characteristics in cases of chronic severe heart failure with different degrees of left ventricular systolic

S V Eriksson1, J Kjekshus, J Offstad

  • 1Department of Internal Medicine, Danderyd Hospital, Sweden.

Cardiology
|January 1, 1994
PubMed

Insights

Patients with severe chronic congestive heart failure and less impaired heart function were older, more often female, and had slower heart rates. Enalapril treatment improved survival, masking prognosis differences seen in the placebo group.

Area of Science:

  • Cardiology
  • Clinical Trials

Background:

  • Demographic differences in severe chronic congestive heart failure (CHF) concerning left ventricular systolic dysfunction (LVD) remain unclear.
  • NYHA Class IV patients in the CONSENSUS-I trial underwent optional evaluation for LVD severity.

Purpose of the Study:

  • To determine if demographic characteristics differ between severe CHF patients with varying degrees of LVD.
  • To investigate the prognostic implications of LVD severity in CHF patients, with and without enalapril treatment.

Main Methods:

  • M-mode echocardiography was used to assess left ventricular fractional shortening (FS) in 54 severe CHF patients.
  • Demographic data (age, sex, heart rate) were compared between patients with FS above and below the median (14%).
  • Two-year follow-up data from the CONSENSUS-I trial were analyzed for survival differences based on FS and treatment group.

Main Results:

  • Patients with FS above the median (less severe LVD) were older, more frequently female, and had lower heart rates compared to those with FS below the median.
  • In the placebo group, higher FS (less severe LVD) correlated with significantly better prognosis.
  • This survival benefit associated with less severe LVD was not observed in the enalapril-treated group, suggesting enalapril mitigated the prognostic impact of LVD severity.

Conclusions:

  • Demographic profiles differ between severe CHF patients with less versus more severe LVD.
  • While less severe LVD predicted better survival in placebo patients, enalapril treatment obscured this difference, indicating a positive impact of the drug on prognosis regardless of baseline LVD severity.

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