Non-invasive prognostic factors in chronic heart failure. One-year survival of 300 patients with a diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy

The prognosis and clinical findings related to prognosis were examined in 300 patients with congestive heart failure in a prospective study. The diagnosis was based on case history data (NYHA class II, or III), depressed ejection fraction (less than or equal to 40%) and/or increased cardiothoracic ratio (greater than or equal to 50%). Forty-eight (16%) patients died within 1 year after the entry examination. Non-invasive baseline parameters of survivors and non-survivors were compared. All necessary medication was allowed. At the entry of the study three parameters independently predicted an increased mortality on a high significance level (P<0.01): cardiothoracic ratio, signs of lung congestion on the chest X-ray (four grade classification), and plasma urea level; other three parameters did so on a lower significance level (P<0.05): plasma natrium, creatinine value and endsystolic volume. Other parameters such as age, ejection fraction, NYHA class or exercise tolerance duration were not statistically different in survivors and non-survivors. Our modification (a four grade classification) of the signs of lung changes on the chest X-ray enables a more accurate determination of the prognosis in patients with chronic heart failure.