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European Heart Journal 2003 24(22):2046-2053; doi:10.1016/j.ehj.2003.07.007
Copyright © 2003 by the European Society of Cardiology.
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Clinical research

Systolic dysfunction is a predictor of long term mortality in men but not in women with heart failure

Manuel Martínez-Sellésa,b,*, José A.García Roblesa, Luis Prietob, Marta Domínguez Muñoaa, Elisa Fradesa, Oscar Díaz-Castroa and Jesus Almendrala

a Cardiology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain
b Statistics Department, Universidad Complutense, Madrid, Spain

* Corresponding author. Manuel Martínez-Sellés, Cardiology Department, Hospital Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007, Madrid, Spain. Tel.: +34-915868276; fax: +34-915868276
E-mail address: mmselles{at}navegalia.com

Received 20 January 2003; revised 23 June 2003; accepted 3 July 2003

Abstract

Aims To evaluate possible gender differences in clinical profile and outcome of patients hospitalised with heart failure.

Methods and results During 1996 a total of 1065 hospital in-patients had confirmed heart failure, with follow-up data through 2002. Women (58%) were significantly older, had higher prevalence of hypertension and diabetes, and lower prevalence of ischaemic heart disease, chronic pulmonary disease and alcoholism. The proportion of patients with normal left ventricular ejection fraction (LVEF) increased with age, but in all age groups women had normal LVEF more frequently than men. Echocardiography was performed less frequently in females: 62% vs. 71% in men, P<0.01, and this finding was consistent in all age groups. During follow-up (median 19 months) 507 patients died (216 men [48.8%] and 291 women [46.8%]). Gender was not a predictor of survival when LVEF was included in the model (RH Male Gender 0.8, 95% CI 0.6 to 1.1, P=0.2). There was a significant interaction gender-LVEF (P=0.048): survival was similar in both genders with LVEF >0.3 but women with LVEF ≤0.3 had a better prognosis than their male counterparts.

Conclusions Survival is similar in women irrespective of LVEF and in men with LVEF >0.3 while men with severely depressed LVEF have a worse prognosis.

Key Words: Heart failure • Sex • Survival


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