Heart 2001;86:172-178 ( August )

Cardiovascular medicine

Cross sectional study estimating prevalence of heart failure and left ventricular systolic dysfunction in community patients at risk O W Nielsen^a, J Hilden^b, C T Larsen^a, J F Hansen^c

^a Cardiovascular Department, Copenhagen University Hospital, DK-2650 Hvidovre, Denmark, ^b Biostatistical Department, Panum Institute, Copenhagen University, 2100 Copenhagen Ø, Denmark, ^c Cardiovascular Department Y, Copenhagen University Hospital, DK-2400 Bispebjerg, Denmark

Correspondence to: Dr Nielsen own{at}dadlnet.dk

Accepted 20 February 2001

OBJECTIVETo examine a general practice population to measure the prevalence of signs and symptoms of heart failure (SSHF) and left ventricular systolic dysfunction (LVSD).
DESIGNCross sectional screening study in three general practices followed by echocardiography.
SETTING AND PATIENTSAll patients  50 years in two general practices and  40 years in one general practice were screened by case record reviews and questionnaires (n = 2158), to identify subjects with some evidence of heart disease. Among these, subjects were sought who had SSHF (n = 115). Of 357 subjects with evidence of heart disease, 252 were eligible for examination, and 126 underwent further cardiological assessment, including 43 with SSHF.
MAIN OUTCOME MEASURESPrevalence of SSHF as defined by a modified Boston index, LVSD defined as an indirectly measured left ventricular ejection fraction  0.45, and numbers of subjects needing an echocardiogram to detect one case with LVSD.
RESULTSSSHF afflicted 0.5% of quadragenarians and rose to 11.7% of octogenarians. Two thirds were handled in primary care only. At  50 years of age 6.4% had SSHF, 2.9% had LVSD, and 1.9% (95% confidence interval 1.3% to 2.5%) had both. To detect one case with LVSD in primary care, 14 patients with evidence of heart disease without SSHF and 5.5 patients with SSHF had to be examined.
CONCLUSIONSSHF is extremely prevalent in the community, especially in primary care, but more than two thirds do not have LVSD. The number of subjects with some evidence of heart disease needing an echocardiogram to detect one case of LVSD is 14.


Keywords: heart failure; left ventricular systolic dysfunction

---

© 2001 by Heart
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Sveen, M.-L., Thune, J. J., Kober, L., Vissing, J. (2008). Cardiac Involvement in Patients With Limb-Girdle Muscular Dystrophy Type 2 and Becker Muscular Dystrophy. Arch Neurol 65: 1196-1201 [Abstract] [Full Text]  
• Mahadevan, G, Davis, R C, Frenneaux, M P, Hobbs, F D R, Lip, G Y H, Sanderson, J E, Davies, M K (2008). Left ventricular ejection fraction: are the revised cut-off points for defining systolic dysfunction sufficiently evidence based?. Heart 94: 426-428 [Full Text]  
• Nielsen, O. W., Sajedieh, A., Petersen, F., Fischer Hansen, J. (2005). Value of left ventricular filling parameters to predict mortality and functional class in patients with heart disease from the community. Eur J Echocardiogr 6: 85-91 [Abstract] [Full Text]  
• Nielsen, O. W., McDonagh, T., Cowburn, P., Blue, L., Robb, S. D., Dargie, H. (2004). Patient differences related to management in general practice and the hospital: a cross-sectional study of heart failure in the community. Eur Heart J 25: 1718-1725 [Abstract] [Full Text]  
• Murphy, N F, Simpson, C R, McAlister, F A, Stewart, S, MacIntyre, K, Kirkpatrick, M, Chalmers, J, Redpath, A, Capewell, S, McMurray, J J V (2004). National survey of the prevalence, incidence, primary care burden, and treatment of heart failure in Scotland. Heart 90: 1129-1136 [Abstract] [Full Text]  
• Schinkel, A F L, Vourvouri, E C, Bax, J J, Boomsma, F, Bountioukos, M, Rizzello, V, Biagini, E, Agricola, E, Elhendy, A, Roelandt, J R T C, Poldermans, D (2004). Relation between left ventricular contractile reserve during low dose dobutamine echocardiography and plasma concentrations of natriuretic peptides. Heart 90: 293-296 [Abstract] [Full Text]  
• Hogg, K., Swedberg, K., McMurray, J. (2004). Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosis. J Am Coll Cardiol 43: 317-327 [Abstract] [Full Text]  
• Nielsen, L. S., Svanegaard, J., Klitgaard, N. A., Egeblad, H. (2004). N-terminal pro-brain natriuretic peptide for discriminating between cardiac and non-cardiac dyspnoea. Eur J Heart Fail 6: 63-70 [Abstract] [Full Text]  
• Wendelboe Nielsen, O, Hilden, J, McDonagh, T, Fischer Hansen, J (2003). Survival differences between heart failure in general practices and in hospitals. Heart 89: 1298-1302 [Abstract] [Full Text]  
• Wang, T. J., Levy, D., Benjamin, E. J., Vasan, R. S. (2003). The Epidemiology of "Asymptomatic" Left Ventricular Systolic Dysfunction: Implications for Screening. ANN INTERN MED 138: 907-916 [Abstract] [Full Text]  
• Nielsen, O. W., McDonagh, T. A., Robb, S. D., Dargie, H. J. (2003). Retrospective analysis of thecost-effectiveness of using plasmabrain natriuretic peptide inscreening for left ventricularsystolic dysfunction in the general population. J Am Coll Cardiol 41: 113-120 [Abstract] [Full Text]  
• McMurray, J.J.V, Stewart, S (2002). The burden of heart failure. Eur Heart J Suppl 4: D50-D58 [Abstract]  
• NIELSEN, O. W., HILDEN, J., HANSEN, J. F. (2001). Strong prognostic value of combining N-terminal atrial natriuretic peptide and ECG to predict death in heart patients from general practice. Heart 86: 218-219 [Full Text]