Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction: Results of the New York heart failure registry

• Published in: Journal of the American College of Cardiology Vol. 43; no. 8; pp. 1432 - 1438
• Main Authors: KLAPHOLZ, Marc, MAURER, Matthew, BERKOWITZ, Robert, MOSKOWITZ, Robert, SONI, Anita, MANCINI, Donna, BIJOU, Rachel, SEHHAT, Khashayar, VARSHNEYA, Nikita, KUKIN, Marrick, KATZ, Stuart D, SLEEPER, Lynn A, LOWE, April M, LE JEMTEL, Thierry H, MESSINEO, Frank, MEISNER, Jay S, MITCHELL, Judith, KALMAN, Jill, PHILLIPS, Robert A, STEINGART, Richard, BROWN, Edward J
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Science 21.04.2004; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiac arrhythmia; Cardiology; Cardiology. Vascular system; Chronic obstructive pulmonary disease; Coronary vessels; Diuretics - therapeutic use; Echocardiography, Doppler; Exercise Test; Female; Heart; Heart attacks; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hospitalization; Humans; Hypertension - complications; Hypertension - physiopathology; Length of Stay; Male; Medical sciences; Middle Aged; Prospective Studies; Risk Factors; Stroke Volume; Ventricular Function, Left - physiology; New York; United States; North America; America; Heart failure; Heart disease; Cardiovascular disease; Ventricular ejection; Hospitalization; Circulatory system; Cardiology; Normal; Phlebology; Left ventricle; Ejection fraction; Result
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2003.11.040

We conducted a prospective multicenter registry in a large metropolitan area to define the clinical characteristics, hospital course, treatment, and factors precipitating decompensation in patients hospitalized for heart failure with a normal ejection fraction (HFNEF). The clinical profile of patients hospitalized for HFNEF has been characterized by retrospective analyses of hospital records and state data banks, with few prospective single-center studies. Patients hospitalized for heart failure (HF) at 24 medical centers in the New York metropolitan area and found to have a left ventricular (LV) ejection fraction of > or 50% within seven days of admission were included in this registry. Patient demographics, signs and symptoms of HF, coexisting and exacerbating cardiovascular and medical conditions, treatment, laboratory tests, procedures, and hospital outcomes data were collected. Analysis by gender and race was prespecified. Of 619 patients, 73% were women, who were on average four years older than men (72.8 +/- 14.1 years vs. 68.6 +/- 13.8 years, p < 0.001). Black non-Hispanic patients comprised 30% of the study population. They were eight years younger than other patients (66.0 +/- 14.2 years vs. 74 +/- 13.5 years p < 0.001). Co-morbid conditions and their prevalence were: hypertension, 78%; increased LV mass, 82%; diabetes, 46%; and obesity, 46%. Before clinical decompensation that precipitated hospitalization, 86% of patients had chronic symptoms compatible with New York Heart Association functional classes II to IV. Factors precipitating clinical decompensation were identified in 53% of patients. In-hospital mortality was 4.2%. Patients hospitalized for HFNEF are most often chronically incapacitated elderly women with a history of hypertension and increased LV mass. Reasons for clinical decompensation are identified in only one-half of patients.