Natural History and Patterns of Current Practice in Heart Fahre

A total of 6,273 consecutive relatkly unseWed patients with heartWureorIeftventrkuIardysRmd&~~(~egc 62*12ycprs,wanejeetioa~31*9%),~earanedin thestudkofLeftvcntrieular~i~LvD)~ overaperiodof14montk.MptientBwerefdbwedRPf~~ sfptUSalldboBpiQl~at1~.IscbcmicbcprtwastheunderlyiBgcauseof~ordyslundknhl=7o%of patkts,whereashpten&eheartdiseasewasplmaluyinvol~~oldy7%.Therewere~~~ere~: theetMogyofheortRuorcamoagbWrsirndwhk73%of white8hadaniuchemkeWogyoff&ihWever!msoxdy36%of bhehs;32%ofblackshodahyperk&vecondithmvwsos~ 4%olnbites.~dDtall-gcpr~rste~18%;19%of pntkeBhadb@#tal admMonsforheartfhihweaml27%either diedorhadahoqiiadn&ionforcon@vehearttWure during the 1st yeBr of fldlow=up. Facters related to l=year mortaliQ or haspital admission for congestive heart failure induded age, @ctie~ &a&n, diabetes meWus, atrial fibrillation and female gender. There was no difkence in mortality associatedwithconge&eheartfidhwoamongblacksandwhites,bnt hqital admissions for heart faike were more frequent in bladcs.Digita&anddhweticogentsn~:rethedragsmostoften used in these patie&, who were ofk i.?Wng many medi~titms ia relatientoseverltyofatqestiveheartfailuresymptemsand ejectien fkactien. Suqhiogly, angietensin-wnve~ enzyme inldbitersweretakenbyenly3O%efpahts,andasubstantW numberwerehatedbydrugsanWoversialiothepresenceefleft vewcuk~naadhealt~,snehascalciumcbalmel aatagenists and aatiarrhythmic or beta-adreaergic blocking agents. (J Am CoU Car&l 1993;22[Sup@e1nen.t A]:MA-9A)