No abstract

The extent of troponin elevation is an independent predictor of morbidity and mortality.

We sought to describe a large heart failure (HF) population with respect to systolic and diastolic abnormalities in terms of demographics, echocardiographic parameters, and survival. Using data abstracted from the Resource Utilization Among Congestive Heart Failure (REACH) study, a targeted subpopulation of 3471 patients had electrocardiographic, echocardiographic, and clinical data taken from automated sources during the first year of diagnosis. Among the HF population, 1811 (52.2%) had diastolic HF. Prevalence of diastolic HF trended with age, from 46.4% in those less than 45 years to 58.7% in those 85 years or older (p=0.001 for trend). Patients with diastolic HF had a higher mean ejection fraction (55.7% vs. 28.0%), lower left ventricular end‐systolic diameter (3.11 vs. 4.74 cm), and lower left atrium: aortic outlet ratio (1.28 vs. 1.38) (p=0.001 for each comparison). Annualized age, sex, and race‐adjusted mortality were 11.2% and 13.0% for those with diastolic and systolic HF, respectively (p=0.001). In a large, racially mixed, urban HF population, those with diastolic HF predominate and enjoy better‐adjusted survival than counterparts with systolic HF.

No abstract

Admission electrocardiography (ECG) in heart failure (HF) patients provides important diagnostic information; however, there are limited data regarding the prognostic significance of ECG parameters for predicting cardiac events (CEs). The ECGs of 246 patients admitted with acute HF were evaluated for heart rate, rhythm, QRS and ST-T wave abnormalities, QTc duration, QT peak corrected (QTpc), T amplitude, and axis. The end points included rehospitalization for a CE or death during 30-day follow-up. There were 71 (29%) patients with CEs. In patients with CEs, atrial fibrillation (AF) was observed more frequently (27% vs 13%, respectively; P=.009) and QTpc was shorter (370+/-43 vs 386+/-44 ms, respectively; P=.020). Multivariate logistic regression analysis revealed that QTpc