| Value of orthopnea, paroxysmal nocturnal dyspnea, and medications in prospective population studies of incident heart failure. | |
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MedLine Citation:
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PMID: 19576357 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Prospective population studies of incident heart failure (HF) are often limited by difficulties in assembling HF-free cohorts. In this study, public-use copies of the Cardiovascular Health Study (CHS) data sets were used to determine the sensitivity, specificity, and positive and negative predictive values of orthopnea and paroxysmal nocturnal dyspnea (PND), with and without the use of medications used in CHS HF criteria (diuretics plus digoxin or vasodilators), in the diagnosis of prevalent HF and in the assembly of a relatively HF-free population. Of the 5,771 community-dwelling older adults aged > or =65 years, 803 had orthopnea, 660 had PND, 1,075 had either symptom, 388 had both symptoms, 547 were using HF medications, and 4,315 had neither symptom and were not using HF medications. Definite HF was centrally adjudicated in 272 participants. The sensitivity, specificity, and positive and negative predictive values for either orthopnea or PND were 52% (95% confidence interval [CI] 46% to 58%), 83% (95% CI 82% to 84%), 13% (95% CI 11% to 15%), and 97% (95% CI 97% to 98%), respectively, and those for either orthopnea or PND or the use of HF medications were 77% (95% CI 72% to 82%), 77% (95% CI 76% to 79%), 14% (95% CI 13% to 16%), and 99% (95% CI 98% to 99%), respectively. In conclusion, only <20% of those with either orthopnea or PND had definite HF, which limits their usefulness in the diagnosis of prevalent HF in the community. However, nearly 99% (negative predictive value) of those with neither symptom nor using HF medications also did not have HF, which may be useful as a simple and inexpensive tool in assembling relatively HF-free cohorts for prospective population studies of incident HF. |
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Authors:
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O James Ekundayo; Virginia J Howard; Monika M Safford; Leslie A McClure; Donna Arnett; Richard M Allman; George Howard; Ali Ahmed |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-05-14 |
Journal Detail:
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Title: The American journal of cardiology Volume: 104 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-06 Completed Date: 2009-07-21 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 259-64 Citation Subset: AIM; IM |
Affiliation:
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University of Alabama at Birmingham, Birmingham, AL, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers Cohort Studies Confidence Intervals Dyspnea / complications*, physiopathology Dyspnea, Paroxysmal / complications*, physiopathology Epidemiologic Studies Female Health Status Indicators Heart Failure / diagnosis*, drug therapy, epidemiology, physiopathology Humans Incidence Male Prognosis Prospective Studies Sensitivity and Specificity United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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P30 AG 031054/AG/NIA NIH HHS; R01 HL 085561/HL/NHLBI NIH HHS; R01 HL 80477-01A1/HL/NHLBI NIH HHS; R01 HL080477-01A1/HL/NHLBI NIH HHS; R01 HL080477-02/HL/NHLBI NIH HHS; R01 HL080477-03/HL/NHLBI NIH HHS; R01 HL080477-04/HL/NHLBI NIH HHS; R01 HL085561-02/HL/NHLBI NIH HHS; R01 HL085561-03/HL/NHLBI NIH HHS; R01 HL085561-04/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
| Comments/Corrections | |
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