Characteristics of Patients Who Die With Heart Failure and a Low Ejection Fraction in the New Millennium
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Accession number;06A0128127
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| Title;Characteristics of Patients Who Die With Heart Failure and a Low Ejection Fraction in the New Millennium |
| Author;
TEUTEBERG JEFFREY J.
(From The Univ. Of Pittsburgh, Cardiovascular Inst., Pittsburgh, Pennsylvania)
LEWIS ELDRIN F.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
NOHRIA ANJU
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
TSANG SUI W.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
FANG JAMES C.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
GIVERTZ MICHAEL M.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
JARCHO JOHN A.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
MUDGE GILBERT H.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
BAUGHMAN KENNETH L.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
STEVENSON LYNNE W.
(Brigham And Women's Hospital, Harvard Medical School, Cardiovascular Div., Boston, Massachusetts)
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Journal Title;J Card Fail
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Journal Code:W1342A
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ISSN:1071-9164
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VOL.12;NO.1;PAGE.47-53(2006)
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| Figure&Table&Reference;FIG.2, TBL.3, REF.23 |
| Pub. Country;United States |
| Language;English |
| Abstract;Therapies for heart failure (HF) with a low ejection fraction (EF) have delayed disease progression and prolonged survival, but the implications of these therapies on the end stages of HF have not been examined. Patients seen by the Brigham and Women's cardiomyopathy service with an EF .LEQ.35%, at least 1 outpatient visit or at least 30 days of follow-up who died between January 1, 2000, and October 20, 2003, were evaluated retrospectively. Of the 160 patients who died since 2000, 80 (50%) were outpatients. In the 6 months before death, 93% of patients had New York Heart Association (NYHA) class III or IV symptoms. The NYHA class, clinical characteristics, medications, and comorbidities differed little between inpatient and outpatient deaths. Renal insufficiency and hyponatremia were worse in the months preceding death than at the time of death (creatinine: 3.2 versus 2.3 mg/dL, P < .0001; sodium: 128 versus 135 mmol/L, P < .0001, respectively). Death was considered sudden in only 21% of patients. Deaths in the current era of HF management occur in patients with long-standing HF characterized by biventricular dysfunction and advanced symptoms. Most deaths are heralded by hyponatremia, acute on chronic renal insufficiency, and frequent hospitalizations. Copyright 2006 Elsevier B.V., Amsterdam.All rights reserved. |
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