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Article: Comparative study on characteristics of congestive heart failure patients with preserved versus abnormal left ventricular systolic function and evaluation effects of therapy

TitleComparative study on characteristics of congestive heart failure patients with preserved versus abnormal left ventricular systolic function and evaluation effects of therapy
不同左心室射血分數老年充血性心力衰竭患者藥物治療的臨床研究
Authors
Issue Date2006
PublisherZhonghua Yixuehui. The Journal's web site is located at http://www.cccm-em120.com/guokanliulan.htm
Citation
Chinese Critical Care Medicine, 2006, v. 18 n. 4, p. 210-215 How to Cite?
AbstractObjective: To compare clinical characteristics and effects of therapy for hospitalized patients with congestive heart failure (CHF) and different left ventricular ejection fraction (LVEF) during hospitalization. Methods: The medical records of 1 074 unselected conse cutive patients with CHF who were admitted to Queen Mary Hospital from January, 2001 to January, 2002 were retrospectively reviewed. Three hundred and ninety-nine patients were categorized as having either normal left ventricular systolic function or systolic dysfunction based on the results of echocardiography. Clinical features with a slightly modified version of the Framingham criteria, laboratory results and drug therapies at discharge were compared. Results: Among patients, the majo rity were women, 95.5% were ≥65 years and 50.6% ≥80 years of age. Classification of the severity of heart failure showed that 70.2% were New York Heart Association (NYHA) III and IV. Only 399 patients had borderline LVEF at the time of hospitalization, of these patients 191 (47.9%) had preserved systolic function (LVEF ≥ 0.50), and 208 (52.1%) with LVEF < 0.50. Patients with LVEF ≥0.50, who tended to be elderly and more often female, exhibited a lower incidence of coronary artery disease and diabetes than patients with LVEF <0.50 (all P<0.05). Patients with preserved systolic function had a significantly higher prevalence of auricular fibrillation (P<0.05), accounting for up to 84 patients (44.0%) with it, and number of hospitalization for CHF increased. Among patients with systolic dysfunction, 22.6% were discharged on a therapeutic regimen of digoxin, 63.0% on an angiotensin-converting enzyme inhibitor (ACEI), and 12.0% on a β - blocker, 13.9% on a calcium channel blocker. These accounted for 62.3%, 35.1%, 9.4% and 18.3% in patients with preserved systolic function, respectively. There was a higher incidence of use of digoxin (P < 0.05). Conclusion: In hospitalized patients with heart failure, th e clinical signs and symptoms of chronic heart failure are similar to those of patients with CHF, LVEF is a powerful prognostic predictor to distinguish CHF patients with normal systolic function from those with systolic dysfunction. Criteria for use of ACEI and β-blocker are still not clear cut. It is important to differentiate CHF patients with LVEF < 0.50 from that with LVEF ≥0.50 in order to achieve a better therapeutic result in the treatment of CHF.
Persistent Identifierhttp://hdl.handle.net/10722/162977
ISSN
2015 SCImago Journal Rankings: 0.141
References

 

DC FieldValueLanguage
dc.contributor.authorZhan, Hen_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorCao, JMen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2012-09-05T05:26:07Z-
dc.date.available2012-09-05T05:26:07Z-
dc.date.issued2006en_US
dc.identifier.citationChinese Critical Care Medicine, 2006, v. 18 n. 4, p. 210-215en_US
dc.identifier.issn1003-0603en_US
dc.identifier.urihttp://hdl.handle.net/10722/162977-
dc.description.abstractObjective: To compare clinical characteristics and effects of therapy for hospitalized patients with congestive heart failure (CHF) and different left ventricular ejection fraction (LVEF) during hospitalization. Methods: The medical records of 1 074 unselected conse cutive patients with CHF who were admitted to Queen Mary Hospital from January, 2001 to January, 2002 were retrospectively reviewed. Three hundred and ninety-nine patients were categorized as having either normal left ventricular systolic function or systolic dysfunction based on the results of echocardiography. Clinical features with a slightly modified version of the Framingham criteria, laboratory results and drug therapies at discharge were compared. Results: Among patients, the majo rity were women, 95.5% were ≥65 years and 50.6% ≥80 years of age. Classification of the severity of heart failure showed that 70.2% were New York Heart Association (NYHA) III and IV. Only 399 patients had borderline LVEF at the time of hospitalization, of these patients 191 (47.9%) had preserved systolic function (LVEF ≥ 0.50), and 208 (52.1%) with LVEF < 0.50. Patients with LVEF ≥0.50, who tended to be elderly and more often female, exhibited a lower incidence of coronary artery disease and diabetes than patients with LVEF <0.50 (all P<0.05). Patients with preserved systolic function had a significantly higher prevalence of auricular fibrillation (P<0.05), accounting for up to 84 patients (44.0%) with it, and number of hospitalization for CHF increased. Among patients with systolic dysfunction, 22.6% were discharged on a therapeutic regimen of digoxin, 63.0% on an angiotensin-converting enzyme inhibitor (ACEI), and 12.0% on a β - blocker, 13.9% on a calcium channel blocker. These accounted for 62.3%, 35.1%, 9.4% and 18.3% in patients with preserved systolic function, respectively. There was a higher incidence of use of digoxin (P < 0.05). Conclusion: In hospitalized patients with heart failure, th e clinical signs and symptoms of chronic heart failure are similar to those of patients with CHF, LVEF is a powerful prognostic predictor to distinguish CHF patients with normal systolic function from those with systolic dysfunction. Criteria for use of ACEI and β-blocker are still not clear cut. It is important to differentiate CHF patients with LVEF < 0.50 from that with LVEF ≥0.50 in order to achieve a better therapeutic result in the treatment of CHF.en_US
dc.languagechien_US
dc.publisherZhonghua Yixuehui. The Journal's web site is located at http://www.cccm-em120.com/guokanliulan.htm-
dc.relation.ispartofChinese Critical Care Medicineen_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Failure - Complications - Drug Therapy - Physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshStroke Volume - Physiologyen_US
dc.subject.meshVentricular Function, Leften_US
dc.titleComparative study on characteristics of congestive heart failure patients with preserved versus abnormal left ventricular systolic function and evaluation effects of therapyen_US
dc.title不同左心室射血分數老年充血性心力衰竭患者藥物治療的臨床研究-
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid16647010-
dc.identifier.scopuseid_2-s2.0-33646577772en_US
dc.identifier.hkuros117111-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646577772&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume18en_US
dc.identifier.issue4en_US
dc.identifier.spage210en_US
dc.identifier.epage215en_US
dc.identifier.scopusauthoridZhan, H=8871654500en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridCao, JM=13411160500en_US
dc.identifier.scopusauthoridLau, CP=35299815500en_US

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