NONINVASIVE 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 increa sed cardiothoracic ratio (greater than or equal to 50%). Forty-eight ( 16%) patients died within 1 year after the entry examination. Non-inva sive 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 s ignificance level (P<0.01): cardiothoracic ratio, signs of lung conges tion on the chest X-ray (four grade classification), and plasma urea l evel; other three parameters did so on a lower significance level (P<0 .05): plasma natrium, creatinine value and endsystolic volume. Other p arameters such as age, ejection fraction, NYHA class or exercise toler ance duration were not statistically different in survivors and non-su rvivors. Our modification (a four grade classification) of the signs o f lung changes on the chest X-ray enables a more accurate determinatio n of the prognosis in patients with chronic heart failure.