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Half of HF Patients Have Preserved Ejection Fraction

Mortality risk similar in those with and without preserved ejection fraction

TUESDAY, Nov. 7 (HealthDay News) -- More than half of heart failure patients in the community have preserved ejection fraction and more than 40 percent have isolated diastolic dysfunction, according to a report in the Nov. 8 issue of the Journal of the American Medical Association. What's more, six-month mortality is similar in those with preserved and reduced ejection fraction.

Francesca Bursi, M.D., M.Sc., of the Mayo Clinic in Rochester, Minn., and colleagues studied 556 patients with heart failure who underwent echocardiography, of whom 308 (55 percent) had preserved ejection fraction of at least 50 percent. This was associated with older age, female sex and no prior history of myocardial infarction.

The investigators found that 242 of patients (44 percent) had isolated diastolic dysfunction. Among those with reduced ejection fraction, there was a 1.67 times greater chance of having moderate or severe diastolic dysfunction compared with those with preserved ejection fraction. Higher levels of brain natriuretic peptide were independently related to low ejection fraction and diastolic dysfunction.

"The prevalence of moderate and severe diastolic dysfunction among patients with heart failure and preserved ejection fraction was strikingly higher than that observed in elderly patients with cardiovascular disease but without heart failure…supporting the hypothesis that diastolic dysfunction is present in a large segment of patients presenting with heart failure and preserved ejection fraction," the authors conclude.

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