Heart failure in elderly patient: non-cardiac determinants of prognosis

Introduction. Heart failure is the common end-result of many different disease processes that impair cardiac function, with an high incidence and prevalence in the elderly, thus representing the first DRG in the departments of Geriatric and Internal Medicine. Objective. The aim of the present study was to evaluate whether non-cardiac determinants can predict clinical outcomes in heart failure. Methods. We retrospectively studied a population of elderly patients consecutively admitted to our Geriatric unit. The average scores of the CIRS (Cumulative Illness Rating Scale), the ADL (Activities Daily Living), the SPMSQ (Short Portable Mental Status Questionnaire) and other clinical parameters have been compared between patients with and without heart failure (III-IV NYHA class). Results. Heart failure patients, especially those with atrial fibrillation (AF) and/or left ventricular hypertrophy (LVH), and those deaths from cardiac cause, were older and showed lower cognitive performance and higher disability and circulating markers of renal failure (creatinine) and inflammation compared to patients without heart failure. Thus, some of these factors could be potential predictors of morbidity and mortality in elderly heart failure patients. Conclusions. Several previous studies have demonstrated the validity of the VMD to predict outcome in elderly patients. The present study suggests that the VDM can be used to predict outcomes also in elderly heart failure patients.