PMID- 19219395
OWN - NLM
STAT- MEDLINE
DCOM- 20090518
LR  - 20211020
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
VI  - 98
IP  - 4
DP  - 2009 Apr
TI  - Clinical variables affecting survival in patients with decompensated diastolic 
      versus systolic heart failure.
PG  - 224-32
LID - 10.1007/s00392-009-0746-1 [doi]
AB  - BACKGROUND: The impact of various clinical variables on long-term survival of 
      patients with acutely decompensated diastolic heart failure (DHF) compared to 
      systolic heart failure (SHF) has not been sufficiently investigated. METHODS: 
      Clinical, laboratory, electrocardiographic and echocardiographic data were 
      collected and analyzed for all-cause mortality in 473 furosemide-treated patients 
      aged >or=60 years, hospitalized for acutely decompensated HF. RESULTS: Diastolic 
      heart failure patients (n = 183) were more likely to be older, female, 
      hypertensive, obese, with shorter preexisting HF duration, atrial fibrillation, 
      lower New York Heart Association (NYHA) class, lower maintenance furosemide 
      dosages, and to receive calcium antagonists. The SHF group (290 patients) 
      demonstrated prevailing coronary artery disease, nitrate or digoxin treatment, 
      and electrocardiographic conduction disturbances (P <or= 0.01 in all 
      comparisons). On median 35-month follow-up, the respective one-, three- and 
      five-year survival rates were 82%, 48% and 33% in DHF versus 74%, 46% and 30% in 
      SHF (P = 0.3). Higher furosemide daily dosage at discharge (OR = 1.24, 95% CI = 
      1.11-1.37, P < 0.001), increasing age (OR = 1.29, 95% CI = 1.09-1.54, P = 0.003), 
      peripheral arterial disease (OR = 1.47, 95% CI = 1.02-2.13, P = 0.043), and a 
      history of stroke (OR = 1.44, 95% CI = 0.98-2.1, P = 0.066) were most 
      significantly associated with shorter survival in SHF. DHF, in turn, demonstrated 
      higher NYHA class (OR = 2.52, 95% CI = 1.48-4.29, P < 0.001), history of 
      non-advanced malignancy (OR = 2.51, 95% CI = 1.3-4.85, P = 0.012), and atrial 
      fibrillation (OR = 1.6, 95% CI = 0.97-2.64, P = 0.066). Antilipid treatment (OR = 
      0.56, 95% CI = 0.3-1.02, P = 0.049) predicted better survival. CONCLUSION: 
      In-patients with acutely decompensated DHF differ from similar SHF subjects with 
      respect to prognostic significance of a number of clinical variables. This 
      observation might carry practical implications.
FAU - Gorelik, Oleg
AU  - Gorelik O
AD  - Department of Internal Medicine F, Assaf Harofeh Medical Center (affiliated to 
      Sackler School of Medicine, Tel Aviv University), Zerifin, Israel. 
      internal6@asaf.health.gov.il
FAU - Almoznino-Sarafian, Dorit
AU  - Almoznino-Sarafian D
FAU - Shteinshnaider, Miriam
AU  - Shteinshnaider M
FAU - Alon, Irena
AU  - Alon I
FAU - Tzur, Irma
AU  - Tzur I
FAU - Sokolsky, Ilya
AU  - Sokolsky I
FAU - Efrati, Shai
AU  - Efrati S
FAU - Babakin, Zoanna
AU  - Babakin Z
FAU - Modai, David
AU  - Modai D
FAU - Cohen, Natan
AU  - Cohen N
LA  - eng
PT  - Journal Article
DEP - 20090213
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
RN  - 0 (Diuretics)
RN  - 0 (Hypolipidemic Agents)
RN  - 7LXU5N7ZO5 (Furosemide)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Diuretics/*administration & dosage
MH  - Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Furosemide/*administration & dosage
MH  - Heart Failure, Diastolic/drug therapy/*mortality/physiopathology
MH  - Heart Failure, Systolic/drug therapy/*mortality/physiopathology
MH  - Humans
MH  - Hypertension/complications
MH  - Hypolipidemic Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications
MH  - Prognosis
MH  - Risk Factors
MH  - Sex Factors
MH  - Survival Rate
MH  - Time Factors
EDAT- 2009/02/17 09:00
MHDA- 2009/05/19 09:00
CRDT- 2009/02/17 09:00
PHST- 2008/07/15 00:00 [received]
PHST- 2009/01/08 00:00 [accepted]
PHST- 2009/02/17 09:00 [entrez]
PHST- 2009/02/17 09:00 [pubmed]
PHST- 2009/05/19 09:00 [medline]
AID - 10.1007/s00392-009-0746-1 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2009 Apr;98(4):224-32. doi: 10.1007/s00392-009-0746-1. Epub 
      2009 Feb 13.