Systolic dysfunction is a predictor of long term mortality in men but not in women with heart failure

Abstract

Survival is similar in women irrespective of LVEF and in men with LVEF >0.3 while men with severely depressed LVEF have a worse prognosis.

Patient Sex Does Not Modify Ejection Fraction as a Predictor of Death in Heart Failure: Insights from the APPROACH Cohort

“…An advantage of this catheterization-based study population was the availability of detailed information about coronary anatomy, which was included in multivariate survival analysis, unlike many previous studies of EF and HF outcomes. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] An important limitation to our results is the 20% of the APPROACH cohort who were either missing an EF measurement, or EF was not measured. It is a clinical reality that EF is not always measured during catheterization.…”

“…18 Male patients with EF <30% had the lowest survival, with similar survival seen in the other sex-EF groups in another study of hospitalized HF patients. 17 In contrast to these previous studies, the current study examined the relationship of patient sex and EF in HF mortality, using geographically representative, province-wide data, with long-term prospective follow-up over greater than 6 years. A wide variety of clinical and process of care variables describing this population were available and included in the survival analysis, but had virtually no effect on the results.…”

“…An interaction between patient sex and EF has been suggested by at least two previous studies. 17,18 We hypothesized that sex modifies the effects of EF on prognosis, such that men with low EF HF would have greater mortality compared to the other groups. We defined low EF as ≤50%, as has been done in previous studies.…”

Análisis transversal de la insuficiencia cardiaca en pacientes de un Servicio de Medicina Interna de un hospital de tercer nivel de área mixta (rural y urbana): Parte III: análisis de mortalidad (Tercera de tres partes)

“…En nuestro estudio no se observaron diferencias entre sexos en ninguno de estos parámetros, sin duda el reducido tamaño muestral podría tener un papel importante en esta limitación, sin embargo también es cierto que estudios de nuestro entorno, realizados también en ambiente hospitalario aportan datos similares, como el de Martínez-Sallez et al (22) o, más recientemente el de Stella M. Macín et al (23).…”

Prognostication of late left ventricular systolic dysfunction in patients with acute coronary syndrome during the acute period

“…It is obvious that the prognostication of the clinical course of LV systolic dysfunction, related to the aforementioned factors (some precipitating and some suppressing its progression), is complicated, as is the relationship of LV systolic dysfunction with heart failure. MartinezSalles et al indicate that LV systolic dysfunction following previous MI is a significant prognostic factor for the evaluation of heart failure and mortality (14). However, in patients with ACS in whom LV systolic dysfunction was detected during the acute period, the prognosis and the relationship of the condition with the development of heart failure (HF) cannot be determined based solely on the decreased LV EF.…”