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Cited by 1,331Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsCardiac pacing and defibrillation studies

Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction

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Vasan, Ramachandran S, Larson, ScD, Martin G, Benjamin, Emelia J, Evans, Jane C, Reiss, Craig K, Levy, Daniel·1999·Journal of the American College of Cardiology
DOI 10.1016/s0735-1097(99)00118-7
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Abstract

Objectives The purpose of this study was to assess the relative proportions of normal versus impaired left ventricular (LV) systolic function among persons with congestive heart failure (CHF) in the community and to compare their long-term mortality during follow-up.Background Several hospital-based investigations have reported that a high proportion of subjects with CHF have normal LV systolic function. The prevalence and prognosis of CHF with normal LV systolic function in the community are not known.Methods We evaluated the echocardiograms of 73 Framingham Heart Study subjects with CHF (33 women, 40 men, mean age 73 years) and 146 age- and gender-matched control subjects (nested case-control study). Impaired LV systolic function was defined as an LV ejection fraction (LVEF) <0.50.Results Thirty-seven CHF cases (51%) had a normal LVEF; 36 (49%) had a reduced LVEF. Women predominated in the former group (65%), whereas men constituted 75% of the latter group. During a median follow-up of 6.2 years, CHF cases with normal LVEF experienced an annual mortality of 8.7% versus 3.0% for matched control subjects (adjusted hazards ratio = 4.06, 95% confidence interval 1.61 to 10.26). Congestive heart failure cases with reduced LVEF had an annual mortality of 18.9% versus 4.1% for matched control subjects (adjusted hazards ratio = 4.31, 95% confidence interval 1.98 to 9.36).Conclusions Normal LV systolic function is often found in persons with CHF in the community and is more common in women than in men. Although CHF cases with normal LVEF have a lower mortality risk than cases with reduced LVEF, they have a fourfold mortality risk compared with control subjects who are free of CHF.

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Authors
Vasan, R. S., Larson, S., Benjamin, E. J., Evans, J. C., Reiss, C. K., & Levy, D.
Affiliations
Boston University (US)
Corresponding author
Levy, Daniel
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1999-06
Volume
33
Issue
7
Pages
1948-1955
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/s0735-1097(99)00118-7
OpenAlex
W1547783254
Cited by
1,331
References
62
Citations by year
2026: 8 · 2025: 5 · 2024: 14 · 2023: 20 · 2022: 13 · 2021: 20 · 2020: 31 · 2019: 27 · 2018: 29 · 2017: 29 · 2016: 29 · 2015: 49 · 2014: 54 · 2013: 49 · 2012: 54
FWCI
31.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (N0I-HC-38038)
  • National Institute of Neurological Disorders and Stroke (2-ROI-NS-17950-11)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
congestive heart failure, left ventricular ejection fraction, normal left ventricular systolic function, long-term mortality, community prevalence, sex differences, Framingham Heart Study
MeSH terms
Adult, Echocardiography, Female, Follow-Up Studies, Heart Failure, Humans, Male, Massachusetts, Middle Aged, Prognosis, Prospective Studies, Stroke Volume, Reproducibility of Results, Prevalence, Survival Rate, Case-Control Studies, Ventricular Function, Left, Ventricular Dysfunction, Left

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