Clinical InvestigationsClinical criteria and biochemical markers for the detection of systolic dysfunction*,**
Section snippets
Study population
The study population comprised 466 consecutive outpatients referred to the Mayo Clinic Echocardiography Laboratory for assessment of systolic function. The reason for referral was identified, and only patients with a primary indication to assess ventricular function were included. The reason for referral was further classified as 1) symptoms of heart failure that included 1 or more of the following: dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, edema, or fatigue; or 2) risk
Patient characteristics
Table 1 reports the clinical characteristics of the patients.Characteristic Total (n = 466) Median age (yr) 65 Male, % of patients 55 Reason for echocardiographic referral, % of patients Symptoms of CHF 33 Risk factors for LV dysfunction 67 Past history, % of patients Hypertension 54 Coronary artery disease 26 Myocardial infarction 10 Diabetes mellitus 15 EF <45%, no. of patients (%) 51(10.9) Medications, % of patients ACE inhibitors 20 β-Blockers 21 Diuretics 30 Nitrates 10
Discussion
We investigated the ability of clinical data and plasma BNP concentration to detect systolic dysfunction in patients being referred to echocardiography to assess systolic function because of symptoms of congestive heart failure or risk factors for systolic dysfunction at a large outpatient echocardiographic laboratory. In this population, the prevalence of a reduced EF (less than 45%) was 10.9%. Patients could be divided into high- and low-risk groups based on either a simple clinical score
Acknowledgements
Dr. Yamamoto was supported by the Fellowship of the Uehara Memorial Foundation.
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Supported in part by grants from the Joseph P. and Jeanne M. Sullivan Foundation, Chicago, Illinois; the Miami Heart Research Institute, Miami, Florida; the National Heart, Lung, and Blood Institute, Bethesda, Maryland (HL-033643); and the Mayo Foundation, Rochester, Minnesota.
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Reprint requests: Margaret M. Redfield, MD, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905.