Predictors of mortality in medically treated patients with congestive heart failure of nonrheumatic etiology and reduced systolic function
Received 30 April 2008; received in revised form 29 July 2008; accepted 24 September 2008. published online 07 November 2008.
Abstract
Objective
We investigated the prognostic value of various parameters on the mortality of patients with nonrheumatic chronic heart failure and left ventricular (LV) systolic dysfunction.
Methods
This study included 132 consecutive patients with congestive heart failure and reduced LV systolic function without rheumatic valve disease. The primary outcome was mortality. Mean follow-up was 38±6 months.
Results
During the follow-up period there were 47 deaths (35.6%). The age (64.1±13.5 vs. 58.7±11.8 years, P=0.019), left bundle branch block (44.7% vs. 18.8%, P=0.002), urea concentration (11.4±5.3 vs. 8.9±4.6 mmol/L, P=0.006), LV end-diastolic and end-systolic dimensions (6.7±0.8 vs. 6.4±0.8 cm, P=0.025 and 5.5±0.8 vs. 4.9±0.8 cm, P<0.001, respectively), grade 3–4 mitral regurgitation (40.4 vs. 22.4%, P<0.001), fractional shortening (16.7±5.3% vs. 19.8±5.7%, P=0.002) and LV ejection fraction (32.9±8.5% vs. 38.7±11.3%, P=0.003) were different between non-survivors and survivors. Multivariate analysis identified severity of mitral regurgitation (OR=1.99, 95% CI 1.18–3.34; P=0.009), age (OR=1.07, 95% CI 1.02–1.12; P=0.01) and LV end-systolic dimension (OR=1.09, 95% CI 1.02–1.16; P=0.014) as independent correlates of mortality.
Conclusions
In medically treated patients with nonrheumatic chronic heart failure and left ventricular systolic dysfunction, severity of mitral regurgitation, age and enlarged LV end-systolic dimension were independently associated with increased risk of death.
aSecond Division of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosova, Prishtina, Kosovo
bDeutsches Herzzentrum, Technische Universität, Munich, Germany
Corresponding author. Service of Cardiology, Clinic of Internal Medicine, University Clinical Centre of Kosova, “Rrethi i Spitalit”, p.n., Prishtina, Kosova. Tel.: +377 44 355 666; fax: +381 38 543 466.
ABSTRACT