PMID- 11431675
OWN - NLM
STAT- MEDLINE
DCOM- 20010809
LR  - 20071115
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 142
IP  - 1
DP  - 2001 Jul
TI  - Chronic heart failure in the very elderly: clinical status, survival, and 
      prognostic factors in 188 patients more than 70 years old.
PG  - 174-80
AB  - BACKGROUND: Chronic heart failure (CHF) is a frequent disease with a dismal 
      prognosis, but little is known about survival in the very elderly. There are no 
      data on the prognostic value of cardiopulmonary exercise testing in this 
      population. We aimed to assess exercise capacity, survival, and prognostic 
      parameters in elderly patients with CHF. METHODS: We evaluated 188 patients with 
      CHF >70 years old (mean 77 +/- 4 years, range 70-94 years) seen at our heart 
      failure clinic between March 1992 and June 1998. A cardiopulmonary exercise test 
      was performed in 102 patients (peak VO2 15.3 +/- 4.7, VE/VCO2 slope 39.6 +/- 
      15.01). All patients were followed up for at least 12 months. The prognostic end 
      point of the study was all-cause mortality. RESULTS: At the end of follow-up (16 
      +/- 10 mo, range 12-41 mo), 67 patients (35.6%) had died (1-year mortality rate 
      26% [95% confidence interval 20-32]). In univariate analysis New York Heart 
      Association class (NYHA) (relative risk [RR] = 2.56, P <.0001), VE/VCO2 (RR = 
      1.041, P <.0001), peak VO2 (RR = 0.87, P =.0007), and fractional shortening (RR = 
      0.95, P <.0001) predicted mortality. Peak VO2 predicted mortality independently 
      of age, NYHA class, and left ventricular ejection fraction. A subgroup of 12 
      patients with dynamic left ventricular outflow tract obstruction during stress 
      had an excellent outcome, with a 100% survival at the end of follow-up (mean 16 
      +/- 7 mo, range 12-39 mo). CONCLUSIONS: The prognosis in elderly patients with 
      CHF is poor. Valid exercise testing results can be obtained in more than 50% of 
      elderly patients with CHF. NYHA class and peak VO2 are the strongest prognostic 
      factors in this population.
FAU - Cicoira, M
AU  - Cicoira M
AD  - Department of Cardiac Medicine, National Heart and Lung Institute, London, United 
      Kingdom. arossi@cardiovr.univr.it
FAU - Davos, C H
AU  - Davos CH
FAU - Florea, V
AU  - Florea V
FAU - Shamim, W
AU  - Shamim W
FAU - Doehner, W
AU  - Doehner W
FAU - Coats, A J
AU  - Coats AJ
FAU - Anker, S D
AU  - Anker SD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Echocardiography
MH  - *Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*mortality/*physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Pulmonary Gas Exchange
MH  - Regression Analysis
MH  - Survival Analysis
EDAT- 2001/06/30 10:00
MHDA- 2001/08/10 10:01
CRDT- 2001/06/30 10:00
PHST- 2001/06/30 10:00 [pubmed]
PHST- 2001/08/10 10:01 [medline]
PHST- 2001/06/30 10:00 [entrez]
AID - S0002-8703(01)34063-2 [pii]
AID - 10.1067/mhj.2001.115796 [doi]
PST - ppublish
SO  - Am Heart J. 2001 Jul;142(1):174-80. doi: 10.1067/mhj.2001.115796.