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Ethnic differences in the prevalence and aetiology of left ventricular systolic dysfunction in the community: the Harrow heart failure watch
  1. G I W Galasko,
  2. R Senior,
  3. A Lahiri
  1. Department of Cardiovascular Medicine, Northwick Park Hospital, Harrow, Middlesex, UK
  1. Correspondence to:
    Dr Gavin Galasko
    Cardiac Research Department, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, UK;


Objective: To assess ethnic differences in the prevalence and aetiology of left ventricular systolic dysfunction (LVSD) in the community.

Design: Community cohort study. All patients underwent echocardiography and those found to have LVSD underwent myocardial perfusion imaging with or without coronary angiography to diagnose underlying coronary artery disease (CAD).

Setting: Seven representative general practices in Harrow, UK, a community hospital, and a local district general hospital.

Patients: 1392 patients ⩾ 45 years old randomly selected from the computer records of seven general practices.

Main outcome measures: The prevalence and aetiology of LVSD in the community, assessing differences between white and non-white populations, and the proportion of patients with LVSD with undiagnosed CAD.

Results: 734 patients (53%) attended, 518 (71%) white and 216 (29%) non-white, the majority South Asian. Thirty nine patients (5.5%) had probable LVSD and 25 (3.5%) definite LVSD. No significant differences in prevalence were seen with ethnicity. CAD underlay most cases of LVSD. Non-white patients had a higher prevalence of CAD as the underlying aetiology of significant LVSD than white patients (100% v 56%, p  =  0.04) and a trend towards less alcoholic cardiomyopathy. 8% of patients with LVSD had undiagnosed CAD.

Conclusions: LVSD is common. White and non-white patients have a similar overall prevalence of LVSD. Non-white patients, the majority South Asians in this study, have a higher prevalence of CAD as the underlying cause for LVSD than white patients. CAD underlies most cases of LVSD in the community, although it may be undiagnosed unless formally assessed.

  • CAD, coronary artery disease
  • CI, confidence interval
  • LVEF, left ventricular ejection fraction
  • LVSD, left ventricular systolic dysfunction
  • MIBI, methoxyisobutylisonitrile
  • SPECT, single photon emission computed tomography
  • left ventricular systolic dysfunction
  • epidemiology
  • aetiology
  • ethnicity
  • heart failure

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  • This study was funded by the Northwick Park Hospital Cardiac Research Fund and a grant from West London Research Network (WeLReN). They had no involvement in the study design or data interpretation.

  • There are no conflicts of interest.

  • Ethical permission was granted by the Harrow Research Ethics Committee

    Authors’ contributions: Gavin Galasko helped design the study, performed most of the echocardiography, analysed and interpreted the data, and wrote the paper. Roxy Senior helped design the study, supervised the echocardiography, and contributed to the writing of the paper. Avijit Lahiri had the initial idea for the study, helped design it, analysed the myocardial perfusion imaging results, and contributed to the writing of the paper.