Skip Navigation

European Journal of Heart Failure 2007 9(9):935-941; doi:10.1016/j.ejheart.2007.06.001
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Adamopoulos, C.
Right arrow Articles by Alla, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Adamopoulos, C.
Right arrow Articles by Alla, F.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2007 European Society of Cardiology

Ejection fraction and blood pressure are important and interactive predictors of 4-week mortality in severe acute heart failure

Chris Adamopoulosa, Faiez Zannadb,*, Renaud Faya, Alexandre Mebazaac, Alain Cohen-Solald, Louis Guizee, Yves Juillièreb and François Allaf

a Clinical Investigation Center of Nancy France
b Department of Cardiology, University Hospital of Nancy France
c Department of Anesthesiology and Critical Care Medecine Hôpital Lariboisère, Paris, France
d Department of Cardiology, Beaujon Hospital France
e Department of Cardiology, University Hospital of Paris-Descartes France
f Department of Epidemiology, University Hospital of Nancy France

* Corresponding author. Centre d'Investigation Clinique (CIC) INSERM-CHU, Hopital Jeanne d'Arc, 54200 Dommartin les Toul, France. Tel.: +33 383 65 66 25; fax: +33 383 65 66 19. E-mail address: f.zannad{at}chu-nancy.fr


  Abstract

Background: In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are independent risk factors in patients with AHFS.

Methods and results: The EFICA study enrolled 581 AHFS patients admitted to 60 CCU/ICUs. Survival at 4 weeks was analyzed for all cases with echocardiographic LVEF available on admission (n%355).

Four-week mortality was 23%. Multivariable analysis identified lower LVEF, lower MAP and serum creatinine >1.5 mg/dl as independent correlates of mortality (respectively, OR: 1.27 per 10% decrease, CI: 1.05–1.53, p%0.012; OR: 1.30 per 10 mmHg decrease, CI: 1.15–1.48, p<0.0001; OR: 2.84, CI: 1.64–4.93, p%0.0002).

LVEF interacted significantly with MAP (p<0.0001) and the subgroup analysis showed that reduced LVEF was a strong risk factor in patients with MAP ≤90 mmHg (OR: 2.73, CI: 1.23–5.98, p%0.01) but did not reach statistical significance in patients with MAP >90 mmHg.

Conclusions: Both LVEF and MAP are important predictors of death in severe AHFS. LVEF can provide additional prognostic information on top of MAP but mainly in patients with low MAP (≤90 mmHg) at admission.

Key Words: Acute heart failure • Ejection fraction • Mean arterial pressure • Critical care

Received October 23, 2006; Revised April 2, 2007; Accepted June 4, 2007


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.