Different prognostic impact of systolic function in patients with heart failure and/or acute myocardial infarction

Aims To study the prognostic importance of left ventricular systolic function in patients with heart failure (HF) and acute myocardial infarction (AMI) with respect to the presence of prior heart failure and known ischemic heart disease. Methods In 13,084 consecutive patients diagnosed with either A...

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Bibliographic Details
Published in:European journal of heart failure 2005-08, Vol.7 (5), p.852-858
Main Authors: Thune, Jens Jakob, Carlsen, Christian, Buch, Pernille, Seibæk, Marie, Burchardt, Hans, Torp-Pedersen, Christian, Køber, Lars
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Aged
Chronic heart failure
Comorbidity
Ejection fraction
Epidemiology
Heart Failure - epidemiology
Heart Failure - physiopathology
Humans
Life Tables
Male
Middle Aged
Myocardial Infarction - epidemiology
Myocardial Infarction - physiopathology
Prognosis
Proportional Hazards Models
Stroke Volume
Systole - physiology
Wall motion index
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Summary:Aims To study the prognostic importance of left ventricular systolic function in patients with heart failure (HF) and acute myocardial infarction (AMI) with respect to the presence of prior heart failure and known ischemic heart disease. Methods In 13,084 consecutive patients diagnosed with either AMI or HF, a medical history and an echocardiographic assessment of left ventricular systolic function by wall motion index (WMI) were obtained. Patients were divided into four groups: AMI with or without a history of HF, and primary HF (no recent AMI) with or without a history of ischemic heart disease (IHD). Mortality was assessed after nine years of follow‐up. Results WMI stratified patients according to all‐cause mortality in all four groups of patients (p< 0.0001). For a decrease in WMI of 0.3 (corresponding to a decrease in left ventricular ejection fraction of 0.1), the hazard ratio was 1.61 (95% CI:1.48–1.76) for AMI patients without prior HF, 1.43 (1.38–1.48) for AMI patients with prior HF, 1.26 (1.22–1.30) for primary HF patients with IHD and 1.23 (1.18–1.27) for HF patients without IHD. Conclusion WMI stratifies patients with IHD and/or HF according to risk of all‐cause death. The presence of HF attenuates the prognostic power of WMI.
ISSN:1388-9842
1879-0844
DOI:10.1016/j.ejheart.2005.01.019