A prospective register of 240 patients with chronic heart failure

pp 560-569

Abstract

We followed prospectively 240 patients with chronic heart failure (according to Framingham criteria). Mean age of the patientes was 55:t 14 years; 84.2 % were men, 45 % were in functional class III-IV and 62 % presented clinical unstabilìty (deterioration during the previous 6 qlonths); 70 % of the patients were on sinus rhythm, and the prevalence of ventricular tachycardia was 28.8 %. Mean values of performed studies were: lef ventricular ejection fraction by radionuclide angiography: 19.4 ± 8.8 %, exercise duration (using a modified Naugton protocol): 10.7 ± 4.3 minutes, echocardiographic end diastolic diameter: 66.1 ±10.3 milimeters; natremia: 136 ± 4.5 miliequivalents fliter. Exercise duration correlationed with functional class and presence of sinus rhythm. Global survival was 74.9 % at one year and 59.8 % at two years. The most powerful predictors of mortality were an advanced functional class and clinical unstability (the last one with a relative risk of 4.26). The other variables (considering in each case the mean value of patient population) were also prognostic, although their relative risks were smaller (1.8-2.2). Presence of atrial fibrillation or ventricular tachycardia was not a predictor of mortality.