Vnitr Lek 1996, 42(1):43-48

[Non-invasive prognostic parameters in chronic heart failure].

J Spinar, J Vítovec, L Spinarová, J Toman: II. interní klinika FN U sv. Anny, Brno.

The relationship between baseline clinical, laboratory and auxiliary indicators on the one-year mortality was investigated in 125 patients with chronic heart failure caused by ischaemic heart disease or cardiomyopathy associated with dilatation. During the baseline examination all patients had cardiac symptoms-functional class NYHA II-IV- and their ejection fraction assessed by echocardiography was < 40% and/or their cardiothoracic index was > 50%. Within twelve months after the baseline examination 19 (15.2%) patients died. Signs of pulmonary congestion and the cardiothoracic index were the most significant prognostic indicator of the one-year mortality (p < 0.001). As to other indicators, the following were statistically significant: sodium level, urea level, the duration of the ergometric test and the patients' body weight. Statistical significance was not recorded in echocardiographic indicators and the NYHA classification. These data, in particular the newly introduced four-grade classification of pulmonary congestion, make it possible to assess a more accurate prognosis of high risk patients with chronic heart failure.