Comparative Study On Characteristics Of Elderly Heart Failure Patients With Different Ejection Function

[Objective] To compare the clinical characteristics, treatment, costs and outcomes in patients with reduced versus preserved left ventricular systolic function.[Methods] The medical records of 345 patients with congestive heart failure who were admitted to our hospital from September 2012 to August2013 were respectively reviewed. The patient were finally included if they had NYHA II-IV,and met the 2014 Chinese Cardiology diagnostic criteria for heart failure.They were categorized into the following three group s: Group I with EF of less than 40 percent(heart failure with reduced ejection fraction, HFr EF),Group II with EF of between from 41 to 49 percent(critical HFp EF), and Group III with left ventricular ejection fraction(EF) more than 50 percent(heart failure with preserved ejection fraction,HFp EF)[Results] The prevalence of Group I, II and III was 35.65%, 20.58% and43.77% respectively. Compared with Group I and II, Group III were more likely to be females, more elderly(p=0.005,0.001),have higher body mass index,and have hypertension(p=0.034,<0.001).The heart-rate of Group I was higherthan Group III(p<0.001).The proportion of NYHAⅢ/Ⅳin Group III was lower than other groups. Group III with hypertension, atrial fibrillation and overweight was more than Group I(p=0.02、0.003、0.013). The stroke and anemia were higher in Group III(p=0.031,0.044),while ischemic cardiomyopathy, smoking and alcoholism were higher in Group I(P=0.014,0.01,0.002), Female, hypertension and atrial fibrillation were the risk factor for HFp EF by Logistic regression analysis. With the EF increased, hemoglobin and hematocrit showed downtrend(p=0.004,0.005).The hypersensitive C reactive protein was significantly higher in Group I, buttriglyceride and high density lipoprotein were lower than Group III(p=0.003,0.043).The levels of NT-pro BNP were decreased with the increased of Left ventricular ejection fraction(p<0.001).Furthermore,with the increased of EF, Left ventricle end diastolic dimension and Left ventricle end systolic dimension were decreased(p<0.001), left atrium was no significant differences(p=0.801).Compared with Group I and II, Group III received less angiotensin converse enzyme inhibitor, angiotensin II receptor blocker, β-blockerdiuretic and digoxin(p<0.001)but more calcium antagonis(p<0.001).The total rehospitalized patients in 12 months because of congestive heart failure were 152(44.06%), which 61 cases(49.59%) in Group I, 29 cases(41.06%) in Group II,and 62 cases(41.06%)in Group III. The total death cases were 42(12.17%),which 15 cases(12.20%) in Group I, 11cases(15.49%) in Group II,and 16 cases(10.60%)in Group III, no significant difference was observed(p=0.305、0.582).[Conclusion] The incidence of HFp EF group was not lower than HFr EF group but with more complication and HFr EF group has poor heart function. Compared to HFr EF group, HFp EF was related to female,hypertension and atrial fibrillation. Thedrugs of treating congestive heart failure by guideline in HFp EF group were less than HFr EF group. The outcome of different ejection fraction patients has no significant difference.