Course and prognosis in patients >=70 years of age with congestive heart failure and normal versus abnormal left ventricular ejection fraction

Congestive heart failure (CHF) affects >3 million Americans, and >400,000 new cases are diagnosed each year.(1) In addition, CHF accounts for >800,000 hospital admissions annually, and >80% of these admissions occur in patients aged >65 years.(2) As a result, CHF is the leading cause of hospitalization in the elderly, and it is also the only major cardiovascular disorder that is currently on the rise in the USA, a fact that is largely attributable to the aging of the population.(3,4) It is now recognized that 30% to 50% of patients with CHF have preserved ventricular systolic function, and that CHF in these patients is often due to abnormal ventricular diastolic relaxation.(5,6) Moreover, the syndrome of diastolic CHF is particularly common in the elderly.(5) Despite the high prevalence of diastolic CHF in the elderly, the prognosis associated with this disorder has not been well characterized, and prior reports have been conflicting.(7,8) This study evaluates the 3- and 12-month prognosis of patients aged greater than or equal to 70 years with CHF and normal systolic function compared with those with reduced contractility, and identifies factors predictive of hospitalization and death in these patients.