Document Detail

Diastolic heart failure in the community: clinical profile, natural history, therapy, and impact of proposed diagnostic criteria.
MedLine Citation:
PMID:  12411978     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Diastolic heart failure (DHF) has been broadly defined as "signs and symptoms of congestive heart failure (CHF) with normal/near normal systolic function." The clinical profile and natural history of the syndrome remain controversial. Furthermore, the frequency with which patients with CHF and normal ejection fraction (EF) fulfill recently proposed standardized diagnostic criteria for DHF is unclear. Our objective was to determine the clinical profile, Doppler echocardiographic features, current management, prognosis, and predictors of outcome of all patients with new onset CHF who had normal EF in Olmsted County, Minnesota, during 1996-1997. The frequency with which patients met recently proposed standardized criteria for diagnosis of DHF was assessed. METHODS: Using the resources of the Rochester Epidemiology Project, all residents of Olmsted County, Minnesota, with a new diagnosis of CHF in 1996-1997, an ejection fraction >45%, and no valve disease (n = 83) were identified. RESULTS: Patients were elderly (79 +/- 13 yr), predominantly female (76%), and had hypertension and/or coronary artery disease (85%). New-onset atrial fibrillation, ischemia, and medical comorbidities were frequently present at diagnosis. Although most patients (81%) met criteria for "probable DHF" by recently proposed clinical criteria, only half of patients met European criteria in which evidence of abnormal function/filling is required. The 1-, 2-, and 3-year mortality rates were 29%, 39%, and 60%, respectively. Angiotensin-converting enzyme inhibition (P =.0008) and beta-blocker (P =.02) therapy were independently associated with improved survival. CONCLUSION: This population-based study provides a comprehensive clinical profile, current management, prognosis, and predictors of outcome of patients with new onset CHF who had normal ejection fraction.
Horng H Chen; John G Lainchbury; Michele Senni; Kent R Bailey; Margaret M Redfield
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  8     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2003-03-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  279-87     Citation Subset:  IM    
Division of Cardiovascular Diseases and the Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
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MeSH Terms
Aged, 80 and over
Blood Pressure / physiology
Community Health Services*
Diastole / physiology
Echocardiography, Doppler
Evidence-Based Medicine
Follow-Up Studies
Heart Failure / diagnosis,  epidemiology,  physiopathology*,  therapy
Heart Valve Diseases / diagnosis,  physiopathology,  therapy
Hypertension / diagnosis,  physiopathology,  therapy
Middle Aged
Minnesota / epidemiology
Risk Factors
Stroke Volume / physiology
Survival Analysis
Treatment Outcome
Ventricular Function, Left / physiology
Grant Support

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