Predictors of Disease Progression and Mortality in Patients with Heart Failure and Preserved Systolic Function

pp 256-263

Abstract

Objectives 
The main objective ofthis study was to analyze the variables associated with mortality and hospitalizations for worsening heart failure in patients with heart failure and preserved sys­tolic function. On the other hand, we built and validated a mortality clinical prediction rule in this population. 

Methods 

From 2279 consecutive patients included in the GESICA heart failure registry, we analyzed 401 individuals with ejec­tion fraction >40%. This group was characterized by a mean age of 70 years old, 41 % of women, 57% in class 111/IV and 24% with ischemic cardiopathy. During the 540 days of fol­low-up, 14.4% ofpatients were hospitalized for the first time due to heart failure and 15.2% died. 

Results 

The only independent variable associated with hospitaliza­tion due to heart failure was the number ofhospitalizations in the previous year: HR l. 72 (1.0-2.97), p=0.05; .2:_2 hospi­talizations: HR 2. 78 (1.15-6. 72), p=0.023. The independent redictive variables of mortality were: functional class, uremia, natremia, chronic obstructive pulmonary disease, male gender, body mass index and systolic blood pressure < 110 or > 140 mmHg. Male gender, chronic obstructive pulmonary disease and high systolic blood pressure predicted mortality only in patients without systolic dysfunction. 

Conclusion 

Among the patients with heart failure and preserved ven­tricular function, the variables associated to a worse clini­cal condition predict higher mortality, whereas previous hospitalizations are associated only to new hospitalizations for worsening of the heart failure.