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Ejection Fractions Up, But Heart Failure Deaths the Same

Mortality rates in those with preserved ejection fraction similar to those with lower ejection fraction

WEDNESDAY, July 19 (HealthDay News) -- The prevalence of heart failure with an ejection fraction greater than 50 percent has increased over the past 15 years, but survival rates for patients with preserved ejection fractions are similar to those with lower ejection fractions, according to two studies in the July 20 issue of the New England Journal of Medicine.

Margaret M. Redfield, M.D., and colleagues from the Mayo Clinic in Rochester, Minn., studied all patients hospitalized at their institution for decompensated heart failure between 1987 and 2001. They found that 47 percent of the 4,596 patients had a preserved ejection fraction and that their proportion had increased over time. However, mortality rates in this group were only slightly better than those with lower ejection fractions and did not improve over time.

Peter P. Liu, M.D., from the University of Toronto in Ontario, Canada, and colleagues found that 31 percent of 2,802 newly diagnosed heart failure patients admitted to Toronto-area hospitals between 1999 and 2001 had ejection fractions of more than 50 percent. However, the 30-day mortality in such patients, who tended to be women with a history of atrial fibrillation, was no different than those with less than 40 percent ejection fraction.

"The two current studies remind us that ejection fraction is not a good predictor of clinical disability and suggest that congestive symptoms are more closely related to the filling (diastolic) properties of the ventricle than to the ejection (systolic) properties," Gerard P. Aurigemma, M.D., writes in an accompanying editorial. He adds, "the development of specific, effective management approaches for diastolic heart failure must also become a high priority."

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