Heart failure in seniors in the conditions of follow-up care wards

Czech version

Authors: L. Pavlíčková; A. Cybulja
Authors‘ workplace: Oddělení geriatrie a následné péče, Thomayerova nemocnice, Praha
Published in: Geriatrie a Gerontologie 2015, 4, č. 1: 5-12
Category: Original Article/Study

Overview

Heart failure has increasing prevalence in the population of seniors. Prognosis of this disease is poor; only 20–30 % of patients survive 5 years from the establishment of the diagnosis.

We have collected data about patients hospitalized for the diagnosis of “heart failure” at the Department of Geriatrics and Follow-up Care of Thomayer hospital in Prague during years 2012 and 2013. We followed 162 patients. 54 % of all patients died during the hospitalization or within one month after discharge. Renal failure and hypalbuminemia was statistically more frequent among the deceased patients. 68 % of survivors used beta-blocker, whereas among deceased patients it was only 55 % (p < 0.1). Patients with systolic dysfunction had higher mortality (62 %) in comparison with patients with preserved systolic function (43 %, p < 0.05). Interesting was high incidence of pulmonary hypertension revealed by echocardiography, especially among patients with preserved systolic function.

More studies are needed to learn about the pathophysiology and appropriate treatment of heart failure among the elderly, especially of heart failure with preserved systolic function of the left ventricle. It would be suitable to prove observed positive effect of beta-blockers for the population of seniors with heart failure.

Keywords:
heart failure – ejection fraction – diastolic dysfunction

Sources

1. Hunt SA, Abraham WT, Chin MH, et al. 2009 Focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A report of the American College of Kardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009; 119: 391–479.

2. Cohen-Solal A, Desnos M, Delahaye F, et al. A national survey of heart failure in French hospitals. The Myocardiopathy and Heart Failure Working Group of the French Society of Cardiology, the National College of General Hospital Cardiologists and the French Geriatrics Society. Eur Heart J 2000; 21(9): 763–769.

3. Masoudi FA, Havranek EP, Krumholz HM. The burden of chronic congestive heart failure in older persons: magnitude and implications for policy and research. Heart Fail Rev 2002; 7: 9 –16.

4. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart 2007; 93: 1137–1146.

5. Stewart S, MacIntyre K, Hole DJ, et al. More ‚malignant‘ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail 2001; 3(3): 315–322.

6. Joffe SW, Webster K, McManus DD, et al. Improved survival after heart failure: a community-based perspective. J Am Heart Assoc 2013; 2(3): 000053.

7. Yancy CW, Jessup M, Bozkurt B, et al. ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 2013; 128(16): 1810–1852.

8. McMurray JJ, Adamopoulos S, Anker SD, et al; ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33(14): 1787–17847.

9. Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet 2003; 362: 777–781.

10. Massie BM, Carson PE, McMurray JJ, et al. Irbesartan in patients with heart failure and preserved ejection fraction. N Engl J Med 2008; 359: 2456–2467.

11. Cleland JG, Tendera M, Adamus J, et al. The perindopril in elderly people with chronic heart failure (PEP-CHF) study. Eur Heart J 2006; 27: 2338–2345.

12. Haq MA, Wong C, Mutha V, et al. Therapeutic interventions for heart failure with preserved ejection fraction: A summary of current evidence. World J Cardiol 2014; 6(2): 67–76.

13. Ghio S, Magrini G, Serio A, et al. Effects of nebivolol in elderly heart failure patients with or without systolic left ventricular dysfunction: results of the SENIORS echocardiographic substudy. Eur Heart J 2006; 27: 562–568.

14. Setaro JF, Zaret BL, Schulman DS, et al. Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance. Am J Cardiol 1990; 66: 981–986.

15. Hung MJ, Cherng WJ, Kuo LT, Wang CH. Effect of verapamil in elderly patients with left ventricular diastolic dysfunction as a cause of congestive heart failure. Int J Clin Pract 2002; 56: 57–62.

16. Vigder C, Ben Israel Y, Meisel SR, et al. Management and 1 year outcome of odest-old hospitalized heart failure patients: a subacute geriatric hospital survey. Isr Med Assoc J 2010; 12(8): 483–488.

17. Komajda M, Hanon O, Hochadel M, et al. Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II. Eur Heart J 2009; 30(4): 478–486.

18. De Geest S, Scheurweghs L, Reynders I, et al. Differences in psychosocial and behavioral profiles between heart failure patients admitted to cardiology and geriatric wards. Eur J Heart Fail 2003; 5(4): 557–567.

19. Heras M, Fernández-Reyes MJ, Sánchez R, et al. Serum uric acid as a marker of all-cause mortality in an elderly patient cohort. Nefrologia 2012; 32(1): 67–72.

20. Sargento L, Satendra M, Almeida I, Sousa C. Nutritional status of geriatric outpatients with systolic heart failure and its prognostic value regarding death or hospitalization, biomarkers and quality of life. J Nutr Health Aging 2013; 17(4): 300–304.

21. Bowling CB, Pitt B, Ahmed MI, et al. Hypokalemia and outcomes in patients with chronic heart failure and chronic kidney disease: findings from propensity-matched studies. Circ Heart Fail 2010; 3(2): 253–260.

22. Maeder MT, Rickenbacher P, Rickli H, Abbühl Het al; TIME-CHF Investigators. N-terminal pro brain natriuretic peptide-guided management in patients with heart failure and preserved ejection fraction: findings from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF). Eur J Heart Fail 2013; 15(10): 1148–1156.

23. Tresch DD, McGough MF. Heart failure with normal systolic function: a common disorder in older people. J Am Geriatr Soc 1995; 43(9): 1035–1042.

24. Pugh ME, Sivarajan L, Wang L, et al. Causes of Pulmonary hypertension in the elderly. Chest 2014.

25. van Empel VP, Kaufmann BA, Bernheim AM, et al. Interaction between Pulmonary Hypertension and Diastolic Dysfunction in an elderly Heart Failure population. J Card Fail 2014; 20(2): 98–104.

26. Karaye KM, Saidu H, Bala MS, Yahaya IA. Prevalence, clinical characteristics and outcome of pulmonary hypertension among admitted heart failure patients. Ann Afr Med 2013; 12(4): 197–204.

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Article was published in

Geriatrics and Gerontology

2015 Issue 1