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Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure.

Abstract：

BACKGROUND:In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are independent risk factors in patients with AHFS. METHODS AND RESULTS:The EFICA study enrolled 581 AHFS patients admitted to 60 CCU/ICUs. Survival at 4 weeks was analyzed for all cases with echocardiographic LVEF available on admission (n=355). Four-week mortality was 23%. Multivariable analysis identified lower LVEF, lower MAP and serum creatinine >1.5 mg/dl as independent correlates of mortality (respectively, OR: 1.27 per 10% decrease, CI: 1.05-1.53, p=0.012; OR: 1.30 per 10 mmHg decrease, CI: 1.15-1.48, p<0.0001; OR: 2.84, CI: 1.64-4.93, p=0.0002). LVEF interacted significantly with MAP (p<0.0001) and the subgroup analysis showed that reduced LVEF was a strong risk factor in patients with MAP 90 mmHg. CONCLUSIONS:Both LVEF and MAP are important predictors of death in severe AHFS. LVEF can provide additional prognostic information on top of MAP but mainly in patients with low MAP (

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Adamopoulos C,Zannad F,Fay R,Mebazaa A,Cohen-Solal A,Guize L,Juillière Y,Alla F

doi

10.1016/j.ejheart.2007.06.001

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

935-41

issue

9

eissn

1388-9842

issn

1879-0844

pii

S1388-9842(07)00250-4

journal_volume

9

pub_type

临床试验,杂志文章

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