PMID- 16500580
OWN - NLM
STAT- MEDLINE
DCOM- 20061003
LR  - 20101118
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 12
IP  - 1
DP  - 2006 Feb
TI  - Characteristics of patients who die with heart failure and a low ejection 
      fraction in the new millennium.
PG  - 47-53
AB  - BACKGROUND: Therapies for heart failure (HF) with a low ejection fraction (EF) 
      have delayed disease progression and prolonged survival, but the implications of 
      these therapies on the end stages of HF have not been examined. METHODS AND 
      RESULTS: Patients seen by the Brigham and Women's cardiomyopathy service with an 
      EF < or =35%, at least 1 outpatient visit or at least 30 days of follow-up who 
      died between January 1, 2000, and October 20, 2003, were evaluated 
      retrospectively. Of the 160 patients who died since 2000, 80 (50%) were 
      outpatients. In the 6 months before death, 93% of patients had New York Heart 
      Association (NYHA) class III or IV symptoms. The NYHA class, clinical 
      characteristics, medications, and comorbidities differed little between inpatient 
      and outpatient deaths. Renal insufficiency and hyponatremia were worse in the 
      months preceding death than at the time of death (creatinine: 3.2 versus 2.3 
      mg/dL, P < .0001; sodium: 128 versus 135 mmol/L, P < .0001, respectively). Death 
      was considered sudden in only 21% of patients. CONCLUSION: Deaths in the current 
      era of HF management occur in patients with long-standing HF characterized by 
      biventricular dysfunction and advanced symptoms. Most deaths are heralded by 
      hyponatremia, acute on chronic renal insufficiency, and frequent 
      hospitalizations.
FAU - Teuteberg, Jeffrey J
AU  - Teuteberg JJ
AD  - University of Pittsburgh, Cardiovascular Institute, Pennsylvania, USA.
FAU - Lewis, Eldrin F
AU  - Lewis EF
FAU - Nohria, Anju
AU  - Nohria A
FAU - Tsang, Sui W
AU  - Tsang SW
FAU - Fang, James C
AU  - Fang JC
FAU - Givertz, Michael M
AU  - Givertz MM
FAU - Jarcho, John A
AU  - Jarcho JA
FAU - Mudge, Gilbert H
AU  - Mudge GH
FAU - Baughman, Kenneth L
AU  - Baughman KL
FAU - Stevenson, Lynne W
AU  - Stevenson LW
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
MH  - Cardiac Output, Low/complications/*mortality/*physiopathology
MH  - Death, Sudden, Cardiac/epidemiology/etiology
MH  - Female
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Hyponatremia/etiology
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Outpatients
MH  - Renal Insufficiency/etiology
MH  - Retrospective Studies
MH  - *Stroke Volume
EDAT- 2006/02/28 09:00
MHDA- 2006/10/04 09:00
CRDT- 2006/02/28 09:00
PHST- 2005/01/28 00:00 [received]
PHST- 2005/06/03 00:00 [revised]
PHST- 2005/08/02 00:00 [accepted]
PHST- 2006/02/28 09:00 [pubmed]
PHST- 2006/10/04 09:00 [medline]
PHST- 2006/02/28 09:00 [entrez]
AID - S1071-9164(05)00818-3 [pii]
AID - 10.1016/j.cardfail.2005.08.001 [doi]
PST - ppublish
SO  - J Card Fail. 2006 Feb;12(1):47-53. doi: 10.1016/j.cardfail.2005.08.001.