Relation of arrhythmias and electrolyte abnormalities to survival in patients with severe chronic heart failure

To investigate the determinants of mortality in patients with chronic congestive heart failure, we prospectively evaluated 84 patients with this disorder who underwent detailed biochemical, clinical, and functional tests at the time of initial evaluation and were then followed for 12 to 52 months (m...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1987-05, Vol.75 (5 Pt 2), p.IV98-I107
Main Authors: Dargie, H J, Cleland, J G, Leckie, B J, Inglis, C G, East, B W, Ford, I
Format: Article
Language:English
Subjects:
Adult
Aged
Amiodarone - therapeutic use
Arrhythmias, Cardiac - etiology
Arrhythmias, Cardiac - physiopathology
Captopril - therapeutic use
Enalapril - therapeutic use
Exercise Test
Female
Heart Failure - drug therapy
Heart Failure - etiology
Heart Failure - mortality
Heart Failure - physiopathology
Heart Ventricles
Humans
Hypokalemia - complications
Hypokalemia - diagnosis
Hyponatremia - complications
Hyponatremia - diagnosis
Male
Middle Aged
Prognosis
Prospective Studies
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Summary:To investigate the determinants of mortality in patients with chronic congestive heart failure, we prospectively evaluated 84 patients with this disorder who underwent detailed biochemical, clinical, and functional tests at the time of initial evaluation and were then followed for 12 to 52 months (mean 31). During this period of follow-up, 58% of the patients died, of whom 71% died suddenly. The most important pretreatment predictor of mortality in these patients was the frequency of ventricular extrasystoles, followed by echocardiographic fractional shortening, a diagnosis of coronary artery disease, and duration of treadmill exercise. The finding of hypokalemia and hyponatremia in these patients at the time of entry into the study was associated with a poor prognosis by univariate analytical methods, but these electrolyte abnormalities did not provide independent prognostic information. The presence of ventricular arrhythmias was related to the severity of left ventricular dysfunction, exercise intolerance, and neurohormonal activation, suggesting that such arrhythmias are multifactorial in origin and may not simply be related to electrolyte abnormalities.
ISSN:0009-7322