Systolic and Diastolic Heart Failure in the Community

CONTEXT The heart failure (HF) syndrome is heterogeneous. While it can be defined by ejection fraction (EF) and diastolic function, data on the characteristics of HF in the community are scarce, as most studies are retrospective, hospital-based, and rely on clinically indicated tests. Further, diast...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2006-11, Vol.296 (18), p.2209-2216
Main Authors: Bursi, Francesca, Weston, Susan A, Redfield, Margaret M, Jacobsen, Steven J, Pakhomov, Serguei, Nkomo, Vuyisile T, Meverden, Ryan A, Roger, Véronique L
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Blood pressure
Cardiac Output, Low - blood
Cardiac Output, Low - diagnostic imaging
Cardiac Output, Low - epidemiology
Cardiac Output, Low - physiopathology
Cardiology. Vascular system
Comorbidity
Diastole
Echocardiography, Doppler
Female
General aspects
Heart
Heart failure
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Logistic Models
Male
Medical sciences
Middle Aged
Natriuretic Peptide, Brain - blood
Peptides
Prospective Studies
Stroke Volume
Survival Analysis
Systole
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - epidemiology
Ventricular Dysfunction, Right - diagnosis
Ventricular Dysfunction, Right - epidemiology
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Summary:CONTEXT The heart failure (HF) syndrome is heterogeneous. While it can be defined by ejection fraction (EF) and diastolic function, data on the characteristics of HF in the community are scarce, as most studies are retrospective, hospital-based, and rely on clinically indicated tests. Further, diastolic function is seldom systematically assessed based on standardized techniques. OBJECTIVE To prospectively measure EF, diastolic function, and brain natriuretic peptide (BNP) in community residents with HF. MAIN OUTCOME MEASURES Echocardiographic measures of EF and diastolic function, measurement of blood levels of BNP, and 6-month mortality. DESIGN, SETTING, AND PARTICIPANTS Olmsted County residents with incident or prevalent HF (inpatients or outpatients) between September 10, 2003, and October 27, 2005, were prospectively recruited to undergo assessment of EF and diastolic function by echocardiography and measurement of BNP. RESULTS A total of 556 study participants underwent echocardiography at HF diagnosis. Preserved EF (≥50%) was present in 308 (55%) and was associated with older age, female sex, and no history of myocardial infarction (all P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.296.18.2209