Abstract
Heart failure is a major health problem in the United States. It is estimated that 4.6 million Americans are currently treated for heart failure and that approximately 550,000 new cases are diagnosed each year.1 Despite advances in therapy, including the widespread use of angiotensin-converting–enzyme inhibitors and the introduction of beta-adrenergic antagonists, mortality associated with heart failure remains high.2 In a recent community-based survey, one-year and five-year survival rates after the onset of heart failure were 76 percent and 35 percent, respectively.3 In 1998, heart failure contributed to 260,000 deaths in the United States.1 The accurate assessment of prognosis in heart . . .