NORMAL LEFT-VENTRICULAR EJECTION FRACTION IN OLDER PERSONS WITH CONGESTIVE-HEART-FAILURE

Study objectives: To investigate in older patients with congestive hea rt failure (CHF) associated with prior myocardial infarction or hypert ension the relationship between normal left ventricular (LV) ejection fraction and age, gender, hypertension, prior myocardial infarction, a nd atrial fibrillation. Design: A prospective study was performed in 5 72 older patients (age >60 years) with CHF associated with prior myoca rdial infarction or hypertension and technically adequate two-dimensio nal echocardiograms for measuring LV ejection fraction. Setting: A lon g-term health-care facility. Patients: One hundred seventy-seven men a nd 395 women, mean age 82+/-8 years, with CHF associated with prior my ocardial infarction or hypertension. Measurements and results: Normal LV ejection fraction (greater than or equal to 50%) occurred in 66 of 177 men (37%) and in 221 of 395 women (56%) (p<0.0001). Multiple logis tic regression analysis showed that independent risk factors for norma l LV ejection fraction in patients with CHF were no prior myocardial i nfarction (p=0.0001; odds ratio=3.048), female gender (p=0.0004; odds ratio=1.978), and age (p=0.018; odds ratio=1.029). Conclusions: Normal LV ejection fraction occurred in 50% of 572 older patients with CHF a ssociated with prior myocardial infarction or hypertension. Independen t risk factors for normal LV ejection fraction in patients with CHF we re no prior myocardial infarction, female gender, and age.