Prognosis

• an enlarged heart (increased left end-diastolic volume ^a or an enlarged cardiothoracic ratio) ^a
• reduced heart rate variability ^a
• reduced or worsening ejection fraction ^b  

Why?

Cardiac enlargement increases the risk of dying

Patient	Prognostic Factor	Outcome	CER	RR (95% CI)	NNF+ (95% CI)
severe heart failure b	increased left ventricular end-diastolic diameter (by 12 mm) independent	death at 15 months	12%	1.69 (1.18 to 2.44)	12 (6 to 45)
	increased cardiothoracic ratio (by 6.5%)  independent			1.62 (1.23 to 2.14)	13 (7 to 35)

Why?

A falling ejection fraction increases the risk of dying

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
heart failure b	ejection fraction per 10% decrease independent	death at 12 months	24%	1.45 (1.39 to 1.50)	14 (12 to 16)