Prognosis in heart failure with preserved left ventricular systolic function: prospective cohort study

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Abstract
Chronic heart failure due to left ventricular systolic impairment is characterised by a poor prognosis and abnormalities of cardiac structure, autonomic and neurohumoral function, and fluid and electrolyte homoeostasis, all of which are thought to contribute to the pathophysiology of this condition. However, some studies have found that 30-50% of all patients with chronic heart failure have preserved left ventricular systolic function.1 Despite this, the natural course of the condition in these patients is controversial, and their pathophysiological characterisation poor. As a result, optimum treatment strategies are unclear. We looked at five year mortality in patients recruited to a large cohort study of chronic heart failure, comparing those having impairment of left ventricular function with those having preserved function. We have published details of the United Kingdom heart failure evaluation and assessment of risk trial (UK-HEART) previously.2 3 Five hundred and fifty three unselected ambulant patients were prospectively recruited from April 1993 to December 1995. Patients were enrolled if they had had stable, symptomatic …