• 作者：Raú ; l Quiró ; s Ló ; pez^a ; ^{quiroslopez77@gmail.com} ; Javier Garc7 ; a Alegr7 ; a^a ; Mar7 ; a Dolores Mart7 ; n Escalante^a ; Javier Trujillo Santos^b ; Mar7 ; a Á ; ngeles Villena Ruiz^a ; Emilio Perea Milla^c ; ¹
• 关键词：Insuficiencia cardiaca ; Pronó ; stico ; Fracció ; n de eyecció ; n
• 刊名：Medicina Cl篓陋nica
• 出版年：2012
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：19 May, 2012
• 卷：138
• 期：14
• 页码：602-608
• 文件大小：341 K

Background and objective

To assess long-term mortality and prognostic factors after initial diagnosis of heart failure (HF), to analyze the differences in function of the left ventricular ejection fraction (preserved [HFPEF] vs. systolic dysfunction [HFSD]) and to compare the results with the main series of incident cases of HF published.

Patients and methods

Retrospective cohort study including patients first diagnosed of heart failure (Framingham criteria), between 1-01-1997 and 31-12-2001, classified according to a left ventricle ejection fraction (LVEF) above or equal to 50%(HFPEF) or below 50%(HFSD). Follow-up of patients was conducted during ten years.

Results

Out of 400 incident cases of heart failure, 231 patients (57,7%) presented with HFPEF. At 10 years, mortality rates were higher in the HFSD group (64,5 vs. 55,4%, p = 0,04). Following a multi-variant analysis, HFPEF mortality was related with age, diabetes mellitus, ischemic heart disease, and chronic renal failure. Treatment with statins and beta-blockers was associated with improved prognosis. Among patients with HFSD, mortality predictors were similar, although patients treated with statins did not show higher survival rates. For other series of incident cases, there were differences in variables related to prognosis and mortality of patients.

Conclusions

After an initial diagnosis of HF, more than half of patients die within 10 years of monitoring. Age, diabetes mellitus, ischemic heart disease and chronic renal failure are all associated with worse prognosis in these patients, whereas the use of beta-blockers and statins is associated with a better prognosis.