Yonsei Med J.  2011 Jan;52(1):33-38. 10.3349/ymj.2011.52.1.33.

Clinical and Echocardiographic Findings of Newly Diagnosed Acute Decompensated Heart Failure in Elderly Patients

• Moon J
• Kang SM
• Cho IJ
• Oh J
• Shim J
• Lee SH
• Jang Y
• Chung N

• KMID: 1106434
• DOI: http://doi.org/10.3349/ymj.2011.52.1.33

Abstract

PURPOSE
Elderly patients (pts) (EPs; > or = 65 years old) with newly diagnosed-acute decompensated heart failure (ND-ADHF) have not yet been studied. The aim of the present study was to investigate clinical characteristics, including echocardiographic findings and prognosis, for EPs with ND-ADHF and to compare those with non-elderly pts (NEPs).
MATERIALS AND METHODS
We retrospectively investigated 256 pts (144 males, 63.0 +/- 14.8 years old) who were admitted to our hospital between January 2005 and March 2009 with ND-ADHF. Clinical characteristics and echocardiographic parameters were analyzed in EPs (n = 135, 58 males) and NEPs (n = 121, 86 males).
RESULTS
In intergroup comparison, female gender, diabetes mellitus, previous stroke and hypertension were more common in EPs. Body mass index (22.3 +/- 4.5 vs. 24.0 +/- 4.4 kg/m2), estimated glomerular filtration rate (54.8 +/- 24.3 vs. 69.2 +/- 30.7 mL/min/m2), C-reactive protein (28.5 +/- 46.9 vs. 7.6 +/- 11.6 mg/dL), hemoglobin (12.3 +/- 2.1 vs. 13.6 +/- 2.3 g/dL) and N-terminal pro-brain natriuretic peptide level (10,538.2 +/- 10,942.3 vs. 6,771.0 +/- 8,964.7 pg/mL) were significantly different (p < 0.05 for all). Early mitral inflow velocity to early diastolic mitral annular velocity (E/E') was significantly higher in EPs than in NEPs (21.2 +/- 9.4 vs. 18.0 +/- 8.9, p < 0.05). During follow-up (44.7 +/- 14.5 months), there were no significant differences in in-hospital mortality, re-hospitalization and cardiovascular mortality between EPs and NEPs (p = NS for all).
CONCLUSION
EPs with ND-ADHF have different clinical characteristics and higher LV filling pressure when compared with NEPs. However, the clinical outcomes for NEPs with ND-ADHF are not necessarily more favorable than those for EPs.

Keyword

Acute heart failure; elderly patients; echocardiography

MeSH Terms

Aged
Echocardiography/*methods
Female
Heart Failure/*diagnosis/*epidemiology
Humans
Male
Middle Aged
Retrospective Studies

Figure

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  Fig. 1 Kaplan-Meier event-free survival curve for re-hospitalization due to heart failure aggravation.

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  Fig. 2 Kaplan-Meier event-free survival curve for cardiovascular mortality.

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