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

Marc Klapholz, Matthew Maurer, April M. Lowe, Frank Messineo, Jay S. Meisner, Judith Mitchell, Jill Kalman, Robert A. Phillips, Richard Steingart, Edward J. Brown, Robert Berkowitz, Robert Moskowitz, Anita Soni, Donna Mancini, Rachel Bijou, Khashayar Sehhat, Nikita Varshneya, Marrick Kukin, Stuart D. Katz, Lynn A. SleeperThierry H. Le Jemtel

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330 Scopus citations

Abstract

Objectives 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). Background 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. Methods 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 ≥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. Results 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%. Conclusions 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.

Original languageEnglish
Pages (from-to)1432-1438
Number of pages7
JournalJournal of the American College of Cardiology
Volume43
Issue number8
DOIs
StatePublished - 21 Apr 2004

Keywords

  • B-NH
  • BP
  • Black non-Hispanic
  • Blood pressure
  • EF
  • Ejection fraction
  • GFR
  • Glomerular filtration rate
  • HF
  • HFNEF
  • Heart failure
  • Heart failure with normal ejection fraction
  • LV
  • Left ventricle/ventricular

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