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    Underlying Cause of Heart Failure Predicts Survival


    The study did not examine the effect of heart function when the patient was first seen, nor of drugs or other treatments given, so "we can't conclude definitively that it was diagnosis [alone] that determined survival," Michael M. Givertz, MD, tells WebMD when asked to review the study. He is clinical director of the cardiomyopathy program at Boston University.

    The researchers looked at survival between 1982 and1997 and found no significant improvement with time. "If you look at this study, as well as at community-based [studies such as from the] Mayo Clinic, we have not seen improvement in survival with time," says Givertz. Medications called "ACE-inhibitors and other medical therapies have been available for more than 10 years, and heart transplant for more than 30 years, yet this has not translated into improved survival.

    "We have good therapies, but they tend to be underutilized in the community," says Givertz. "There is a need for education among primary care physicians as well as cardiologists. We could all be more aggressive in the vigorous evaluation, treatment, and follow-up of heart failure, including medical and nonmedical therapies such as diet and exercise. ... These nonmedical therapies may be especially important in ... improving quality of life."

    Suggestions for improving your diet and developing an exercise program to decrease the risk of heart disease and improve quality of life in heart failure can be found at the American Heart Association's web site.

    Vital Information:

    • Heart failure occurs when the heart muscle doesn't pump as well as it should, and all cases are often lumped together and diagnosed as cardiomyopathy.
    • New research shows, however, that the underlying cause of cardiomyopathy can be important because it helps predict how long a person with the disease will live.
    • A biopsy of the heart can help determine the cause of cardiomyopathy, but in some patients no definite diagnosis can ever be made.
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