OUTCOME IN PATIENTS WITH CARDIAC FAILURE AND NORMAL LEFT
VENTRICULAR SYSTOLIC CONTRACTION. S. Nicholls*, B. Bastian, J. Lowe, K.
Inder, P. Candlish, J. Holliday and D. O'Connell. John Hunter Hospital, Newcastle. Background: Patients with cardiac failure and impaired left ventricular
systolic contraction (ILVSC) stand to benefit from various pharmacologic
therapies. The aim of this study was to
analyse the therapy administered and outcome in patients with cardiac failure
and normal left ventricular systolic contraction (NLVSC). Method:
141 consecutive patients were admitted with cardiac failure on clinical
grounds. Clinical records,
echocardiograms and outcome were reviewed. Results:
37 patients had normal left ventricular systolic contraction. Medication use did not differ significantly
between the two groups. Drug NLVSC ILVSC AEC
Inhibitor 74% 74% Angiotensin
II Blocker 8% 15% Beta
Blocker 24% 30% Digoxin 44% 44% Diuretic 90% 93% Calcium
antagonist 18% 15% Nitrates 44% 41% Hydralazine 2% 0 Antiarrhythmics 12% 15% Those with normal left ventricular systolic
contraction did not significantly differ in terms of 28 day readmission (11% v
13%), 28 day mortality (16% v 10%) and 12 month mortality (38% v 33%). In those with impaired systolic contraction,
no trend was seen between degree of impairment and outcome. Conclusion: In patients who present with cardiac failure the absence of
apparent systolic dysfunction does not appear to influence therapy and outcome.
