Author + information
- Received May 27, 2003
- Revision received November 8, 2003
- Accepted November 17, 2003
- Published online April 21, 2004.
- Marc Klapholz, MD*,
- Matthew Maurer, MD†,
- April M. Lowe, MS‡,
- Frank Messineo, MD§,
- Jay S. Meisner, MD, PhD∥,
- Judith Mitchell, MD¶,
- Jill Kalman, MD#,
- Robert A. Phillips, MD, PhD**,
- Richard Steingart, MD††,
- Edward J. Brown Jr, MD‡‡,
- Robert Berkowitz, MD, PhD§§,
- Robert Moskowitz, MD∥∥,
- Anita Soni, MD¶¶,
- Donna Mancini, MD†,
- Rachel Bijou, MD†,
- Khashayar Sehhat, MD***,
- Nikita Varshneya, MD*,
- Marrick Kukin, MD**,
- Stuart D. Katz, MD†,
- Lynn A. Sleeper, ScD‡,
- Thierry H. Le Jemtel, MD*,††† (, )
- New York Heart Failure Consortium
- ↵*Reprint requests and correspondence:
Dr. Thierry H. Le Jemtel, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA.
Objectives We conducted a prospective multicenter registry in a large metropolitan area to define the clinical characteristics, hospital course, treatment, and factors precipitating decompensation in patients hospitalized for heart failure with a normal ejection fraction (HFNEF).
Background The clinical profile of patients hospitalized for HFNEF has been characterized by retrospective analyses of hospital records and state data banks, with few prospective single-center studies.
Methods Patients hospitalized for heart failure (HF) at 24 medical centers in the New York metropolitan area and found to have a left ventricular (LV) ejection fraction of ≥50% within seven days of admission were included in this registry. Patient demographics, signs and symptoms of HF, coexisting and exacerbating cardiovascular and medical conditions, treatment, laboratory tests, procedures, and hospital outcomes data were collected. Analysis by gender and race was prespecified.
Results Of 619 patients, 73% were women, who were on average four years older than men (72.8 ± 14.1 years vs. 68.6 ± 13.8 years, p < 0.001). Black non-Hispanic patients comprised 30% of the study population. They were eight years younger than other patients (66.0 ± 14.2 years vs. 74 ± 13.5 years p < 0.001). Co-morbid conditions and their prevalence were: hypertension, 78%; increased LV mass, 82%; diabetes, 46%; and obesity, 46%. Before clinical decompensation that precipitated hospitalization, 86% of patients had chronic symptoms compatible with New York Heart Association functional classes II to IV. Factors precipitating clinical decompensation were identified in 53% of patients. In-hospital mortality was 4.2%.
Conclusions Patients hospitalized for HFNEF are most often chronically incapacitated elderly women with a history of hypertension and increased LV mass. Reasons for clinical decompensation are identified in only one-half of patients.
☆ Educational grants from Merck and GlaxoSmith-Kline pharmaceuticals supported the development of the Internet applications and statistical analyses.
- Received May 27, 2003.
- Revision received November 8, 2003.
- Accepted November 17, 2003.
- American College of Cardiology Foundation