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Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction

Prevalence and mortality in a population-based cohort

Ramachandran S. Vasan, MD, FACC^{* ,1}, Martin G. Larson, ScD^* , Emelia J. Benjamin, MD, ScM, FACC^* , Jane C. Evans, MPH^* , Craig K. Reiss, MD, FACC^|| and Daniel Levy, MD, FACC^{* ¶}

^* National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, USA
Division of Cardiology and Division of Clinical Epidemiology, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts, USA
Cardiology Section, Boston Medical Center, Boston, Massachusetts, USA
Department of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, USA
^|| Barnes Hospital, St. Louis, Missouri, USA
^¶ National Heart, Lung and Blood Institute, Bethesda, Maryland, USA

View larger version (24K): [in a new window]   Figure 1 The distribution of left ventricular ejection fraction (LVEF) values among men and women with congestive heart failure is displayed in the figure. Twenty-seven of 40 men (67.5%) had a reduced LVEF (<0.50), compared with only nine of 33 women (27%).

View larger version (19K): [in a new window]   Figure 2 Kaplan-Meier survival plots of control and congestive heart failure (CHF) subjects with reduced left ventricular ejection fraction (LVEF) are displayed. Survival of men (A) and women (B) with CHF with reduced LVEF was lower than that of age-matched control subjects of the same gender. The overall 5-year survival for CHF cases with reduced LVEF was only 36%, compared with 78% for matched control subjects (log-rank p < 0.0001).

View larger version (19K): [in a new window]   Figure 3 Kaplan-Meier survival plots of control and CHF subjects with normal LVEF are displayed. Survival of men (A) and women (B) with CHF with normal LVEF was lower than that of age-matched control subjects of the same gender. The overall 5-year survival was 68% for CHF cases with normal LVEF, compared with 82% for matched control subjects (log-rank p < 0.0001). Abbreviations as in Figure 2.

View larger version (15K): [in a new window]   Figure 4 Kaplan-Meier survival plots of CHF patients with normal and reduced LVEF are displayed. The overall survival of CHF subjects with reduced LVEF is worse than that of CHF subjects who have a normal LVEF. This comparison does not account for gender differences in the composition of the two groups. Abbreviations as in Figure 2.