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Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction

Results of the New York heart failure registry

Marc Klapholz, MD^*, Matthew Maurer, MD, April M. Lowe, MS, Frank Messineo, MD, Jay S. Meisner, MD, PhD^||, Judith Mitchell, MD^¶, Jill Kalman, MD^#, Robert A. Phillips, MD, PhD^**, Richard Steingart, MD, Edward J. Brown, Jr, MD, Robert Berkowitz, MD, PhD, Robert Moskowitz, MD^||||, Anita Soni, MD^¶¶, Donna Mancini, MD, Rachel Bijou, MD, Khashayar Sehhat, MD^***, Nikita Varshneya, MD^*, Marrick Kukin, MD^**, Stuart D. Katz, MD, Lynn A. Sleeper, ScD, Thierry H. Le Jemtel, MD^*, New York Heart Failure Consortium

^* Saint Vincent Catholic Medical Centers, New York, New York, USA
Columbia Presbyterian Medical Center, New York, New York, USA
New England Research Institutes, Watertown, Massachusetts, USA
New York Hospital, Queens, New York, USA
^|| Jacobi Medical Center, Bronx, New York, USA
^¶ SUNY Health Science Center, Brooklyn, New York, USA
^# Beth Israel Medical Center, New York, New York, USA
^** Mount Sinai Medical Center, New York, New York, USA
Winthrop Hospital, Mineola, New York, USA
Lincoln Hospital, Bronx, New York, USA
Valley Hospital, Ridgewood, New Jersey, USA
^|||| Montefiore Medical Center, Bronx, New York, USA
^¶¶ Bronx Lebanon Hospital, Bronx, New York, USA
^*** Our Lady of Mercy Medical Center, Bronx, New York, USA
Albert Einstein College of Medicine, Bronx, New York, USA

View larger version (13K): [in a new window]   Figure 1 Cardiovascular or medical conditions and new events precipitating hospitalization. Ranked by prevalence. *Syst. BP = systolic blood pressure upon presentation (emergency department); non-compliance = non-compliance with medication; MR/AR = mitral regurgitation/aortic regurgitation (severity scale from 1+ to 4+); ACS = acute coronary syndrome; ||baseline dialysis or creatinine >3 mg/dl; ¶Afib/Flutter/SVT= atrial fibrillation or atrial flutter/supraventricular tachycardia—<1 week duration or heart rate 130 beats/min; #COPD = chronic obstructive pulmonary disease—severe was defined by pulmonary function tests or by the need for systemic steroid therapy; **AS/MS = aortic stenosis/mitral stenosis.

View larger version (13K): [in a new window]   Figure 2 Percentage of patients at presentation (open bars), and at discharge (solid bars) receiving diuretics, angiotensin-converting enzyme inhibitors (ACEI), beta-blockers (BB), calcium channel blockers (CCB), digoxin (DIG), angiotensin II receptor blockers (ARB), and aldactone (ALDACT).

View larger version (43K): [in a new window]   Figure 3 Mean systolic (hatched bars) and diastolic (solid bars) blood pressures upon presentation (emergency department) and at discharge in the entire cohort of patients (Total) and according to racial background (Black non-Hispanic [B-NH] and Others). Blood pressure (mm Hg) upon presentation: B-NH 172 of 92, Other 155 of 81, Total 160 of 84. Blood pressure (mm Hg) on discharge: B-NH 137 of 75, Other 130 of 71, Total 132 of 72.