Long-term prognosis of chronic heart failure in the elderly

Abstract

To elucidate the predictors of the mortality rate in the elderly with chronic heart failure (HF), 120 consecutive patients (mean age 57.2 ± 7.8 years) with heart failure (NYHA I-II) were analyzed prospectively for 5 years. [Methods] Left ventricular ejection fraction (EF), left ventricular diastolic and systolic dimension (LVDD and LVDS) and wall thickness (WT) were measured echocardiogram. Venipuncture for measurement of ANP and norepinephrine (NE) was done is supine position after 30 minutes rest. [Results] 1) HF was associated with hypertension (47.5%), ischemic heart disease (35%), valvular disease (15%) and atrial fibrillation (AF, 23%), 2) 15 and 11 patients died for cardiac and non-cardiac events, respectively, 3) There was no difference in mean ages, gender, blood pressure, plasma-NE, EF, LVD, LVDA, WT and AF between cardiac death and control groups. However, plasma ANP was higher in cardiac death group (173 pg/ml) than in control group (76 pg/ml) (p < 0.01), 4) Cox proportional hazard regression model revealed that ANP was an independent predictor for cardiac death (p < 0.005). We concluded that only plasma ANP level predicts long-term prognosis of chronic heart failure in the elderly.