Document Detail


Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: the INDYCE registry.
MedLine Citation:
PMID:  20800799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The distribution of left ventricular ejection fraction (LVEF) - a key factor in coronary artery disease (CAD) patient management and prognostication - is poorly documented.
OBJECTIVE: To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France.
METHODS: The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded.
RESULTS: Overall, 3119 patients (68.4 +/- 11.0 years; 80% men) were enrolled. LVEF was 56.1+/-11.8% on average, and was poor (<40%) and moderately impaired (40-50%) in 9.6% (n=298) and 19.8% (n=619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class < or = I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59-5.63; P<0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration.
CONCLUSION: Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR>or=70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.
Authors:
Jean-Yves Tabet; Marie-Christine Malergue; Maxime Guenoun; Franck Paganelli; Philippe Meurin; Didier Not; Patrick Jourdain; Dominique Guedj-Meynier;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-07-23
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  103     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:    2010 Jun-Jul
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-13     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  354-62     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Masson SAS. All rights reserved.
Affiliation:
Les Grands Prés, 77174 Villeneuve Saint-Denis, France. jtabet@free.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure
Cardiovascular Agents / therapeutic use
Chi-Square Distribution
Coronary Artery Disease / drug therapy,  epidemiology,  physiopathology*,  ultrasonography
Cross-Sectional Studies
Female
France / epidemiology
Heart Rate*
Humans
Logistic Models
Male
Middle Aged
Outpatients
Prospective Studies
Registries
Stroke Volume*
Treatment Outcome
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

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