Prognostic factors and predictors of in-hospital mortality of patients with heart failure with preserved left ventricular ejection fraction

Background and aim To date, in-hospital mortality predictors of patients with heart failure and depressed left ventricular ejection fraction are well known. Nevertheless, this is not the case of patients suffering from heart failure with preserved left ventricular ejection fraction. Our aim is to describe the incidence and predictors of in-hospital mortality in patients during the first admission due to preserved left ventricular ejection fraction. Methods Seven hundred and seventy-one consecutive patients with a first admission to hospital due to preserved left ventricular ejection fraction between January 2002 and September 2003 comprised our study group. Cardiovascular risk factors, clinical, electrical and echocardiographic variables were studied. Univariate and multivariate logistic regression analysis was performed to obtain those factors independently associated with in-hospital mortality. Results The mean age was 82.6 +/- 43.6 years (551 women, 66.3%). Variables in both groups were similar except for the history of ischaemic heart disease, dilated cardiomyopathy and the presence of normal sinus rhythm. Multivariate logistic regression analysis showed that a history of ischaemic heart disease, dilated cardiomyopathy and a cardiac rhythm different from normal sinus rhythm are associated with an increased in-hospital mortality. Conclusion Patients with preserved left ventricular ejection fraction have high in-hospital mortality during the first admission. A history of ischaemic heart disease, a history of dilated cardiomyopathy and the presence of a cardiac rhythm different from the normal sinus rhythm (atrial fibrillation or flutter or paced rhythm) are independent predictors of in-hospital mortality in these patients. These factors must especially be considered during the admission of such patients.