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Heart Failure Prognosis Better with Hypertensive Etiology

Study shows LVEF likely to improve in patients with hypertensive, rather than ischemic, cause of heart failure

FRIDAY, Dec. 22 (HealthDay News) -- Patients with chronic heart failure due to hypertension have a better chance of an improvement in left ventricular ejection fraction (LVEF) after treatment than those with heart failure due to ischemia, according to a report in the Dec. 15 issue of the American Journal of Cardiology.

Flora Sam, M.D., and colleagues at Boston University, investigated the predictors of improved left ventricular function in 71 ethnically diverse, ambulatory patients with chronic heart failure who showed better LVEF during a follow-up of six months or greater.

Compared with 142 age- and gender-matched control patients who showed no improvement during the same time, the improved group had a lower incidence of diabetes mellitus (19.7 versus 36.6 percent) and lower prevalence for ischemic cause of disease (8.4 versus 35.2 percent). After adjustments, a hypertensive etiology was the stronger predictor of improvement, giving an adjusted odds ratio of 9.73.

"Because long-term prognosis and indication for defibrillator implantation may be affected by changes in left ventricular function, the present study provides additional support for the importance of evaluating the cause of heart failure to guide management," the authors conclude.

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