Document Detail


Prevalence and predictors of heart failure with preserved systolic function: community hospital admissions of a racially and gender diverse elderly population.
MedLine Citation:
PMID:  14966775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The reported prevalence of preserved systolic function (PSF) heart failure (HF) varies widely and has not been well-studied in nonwhite patients. To estimate the prevalence of PSF HF resulting in hospital admission, we studied admissions to a large community hospital serving a racially diverse community. METHODS: The charts of 300 consecutive patients > or =65 years old with a primary discharge diagnosis of HF were reviewed. In patients who met the Framingham criteria for HF diagnosis, an assessment of left ventricular function was obtained from review of chart data. Comparison of baseline characteristics and multivariate analysis of potential predictors of PSF HF was undertaken. RESULTS: Of the 300 patients, 247 (82%) met the Framingham criteria for diagnosis of HF. Ninety-seven patients (39%) of these had PSF. Twenty (8%) of the diagnosed HF patients had a diagnosis of severe aortic or mitral valvular disease, 9 of whom had preserved systolic functions. Thus 88 (36%) of the HF patients had PSF HF likely resulting from diastolic dysfunction. On multivariate analysis, age, hypertension at presentation, peripheral edema, normal sinus rhythm and a history of coronary artery bypass grafting or coronary angioplasty were significantly associated with PSF HF rather than HF with reduced systolic function. Left bundle branch block or other intraventricular conduction delay was independently associated with reduced systolic function HF. However, because these findings occurred in patients with and without systolic dysfunction, none were pathognomonic of PSF HF. CONCLUSION: In this racially diverse, majority nonwhite, cohort of older patients admitted for HF, the Framingham criteria for the diagnosis of HF were met in 82% of the patients. Of these, 39% had PSF HF and 36% had PSF HF in the absence of severe aortic or mitral valve disease, suggesting that diastolic dysfunction was etiologic. Although there was an independent association of PSF HF with a number of clinical characteristics, none of these characteristics was pathognomonic of preserved, versus reduced, systolic function HF.
Authors:
Eliot Peyster; James Norman; Michael Domanski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  10     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-17     Completed Date:  2004-08-30     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:  49-54     Citation Subset:  IM    
Affiliation:
The Clinical Trials Group, Division of Heart and Vascular Diseases, National Heart, Lung, and Blood Institute/NIH, Two Rockledge Center, 6701 Rockledge Drive, MSC 7936, Bethesda, MD 20892, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Blood Pressure / physiology*
Cohort Studies
Community Health Services
Cross-Sectional Studies
Cultural Diversity
Female
Heart Failure / epidemiology*,  ethnology,  physiopathology
Hospitals, Community / statistics & numerical data
Humans
Hypertension / epidemiology
Hypertrophy, Left Ventricular / epidemiology
Male
Maryland / epidemiology
Multivariate Analysis
Patient Admission / statistics & numerical data
Prevalence
Retrospective Studies
Sex Factors
Ventricular Function, Left / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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