Situación actual de la insuficiencia cardíaca con fracción de eyección del ventrículo izquierdo preservada en un hospital general nivel 2

  1. MARTINEZ SANTOS, PAULA
Supervised by:
  1. María Dolores Martín Ríos Director
  2. Carlos Macaya Miguel Director
  3. Isidro Vila Costa Director

Defence university: Universidad Complutense de Madrid

Fecha de defensa: 14 September 2014

Committee:
  1. José María Ladero Quesada Chair
  2. Elpidio Miguel Calvo Manuel Secretary
  3. Benjamín Herreros Ruiz-Valdepeñas Committee member
  4. Carlos Guijarro Herráiz Committee member
  5. Lorenzo López-Bescós Committee member
Department:
  1. Medicina

Type: Thesis

Teseo: 118970 DIALNET

Abstract

"Background": The left ventricle ejection fraction (LVEF) has been proposed as a defining trait of heart failure (HF) in two different clinical entities. Hospitalized patients for heart failure with preserved ejection fraction (HF PEF) present a specific profile. "Aims": The aims of this study were to describe the main features of hospitalized patients for HF PEF and to identify the prognostic factors related to mortality or readmission for HF. "Methods and results": We prospectively evaluated 154 consecutive patients hospitalized for HF PEF (LVEF ≥50%) in a secondary hospital between 2011 and 2012. All patients were followed for one year after discharge. Data related to HF rehospitalization and/or to all-cause mortality were collected during this period. Average patient age was 81 and 63% were women. Anaemia, hypertension and atrial fibrillation were the most prevalent comorbidities among these patients. The mortality rate was 24%. In multivariable analysis, age over 80 years (OR 5.59; 1.60-22.48 CI 95%, p = 0.008), plasma N-terminal brain natriuretic peptide (NT proBNP) higher than the median (OR 5.36; 1.84-15.65 CI 95%, p = 0.002) and the need of chronic oxygen therapy (OR 4.19; 1.51-11.59 CI 95%, p = 0.006) were associated with a higher risk of death. Out of the 82 patients without a prior history of HF, the Cox regression model indentified plasma levels of NT proBNP higher than 1822.5ng/l (HR 3.67; 1.22-11.05 CI 95%, p = 0.021) as the single most important independent predictor of readmission for HF. "Conclusions": HF PEF is common among octogenarians. Age, increased plasma levels of NT proBNP and long-term supplemental oxygen therapy are related to poor prognosis at follow up