Prognosis of congestive heart failure in elderly patients with normal versus abnormal left ventricular systolic function associated with coronary artery disease

Congestive heart failure (CHF) is an abnormal condition characterized by circulatory congestion. It is caused by heart disorders or heart attack, and has a high mortality. One study found the five-year mortality to be 62 percent for men and 42 percent for women. Another study found the three-year mortality for CHF caused by coronary artery disease or dilation of the heart muscle (cardiomyopathy) to be 76 percent. CHF may occur with a normal or an abnormal ejection fraction (the proportion of blood that is ejected from the left ventricle at each compression; an indicator of cardiac function). Normal was defined as an ejection fraction above 50 percent. In this study, 247 had CHF, and of these 166 had certain qualifying conditions. All were elderly patients in a long-term health care facility. Forty-one percent had a normal ejection fraction. Echocardiography and Doppler studies are very important in the management of patients with CHF, determining which patients are candidates for valvular heart surgery. For these patients the most important determinant of mortality was the left ventricular ejection fraction. At the end of four years, 44 percent of patients with normal ejection fraction were alive, versus 15 percent of those with an abnormal ejection fraction. This was true even though the patients with a normal ejection fraction were older. In a different trial, average annual mortality was 8 percent for those with normal ejection fraction, and 19 percent for those with an abnormal ejection fraction. Hypertension and age also predicted death in patients with CHF associated with coronary artery disease. (Consumer Summary produced by Reliance Medical Information, Inc.)