Abstract. Kupari M, Lindroos M, Iivanainen AM, Heikkila$ J, Tilvis R. (Helsinki University Central Hospital, Helsinki, Finland). Congestive heart failure in old age : prevalence, mechanisms and 4-year prognosis in the Helsinki Ageing Study. J Int Med 1997 ; 241 : 387-94.Objective. To examine the prevalence, underlying diseases, abnormalities of left ventricular function and prognosis in congestive heart failure (CHF) of old age. Design. A population-based clinical and echocardiographic study with a 4-year mortality followup. Setting. University hospital. 1904, 1909 and 1914 (367 women). Main outcome measures. Presence of CHF by clinical and chest radiograph criteria ; left ventricular size and systolic function by echocardiography ; grade of aortic and mitral valve lesions by Doppler echocardiography ; 4-year total and cardiovascular mortality. Results. Forty-one of 501 participants (8.2 %) had CHF. Ischaemic heart disease (54 %), hypertension (54 %) and moderate-to-severe mitral or aortic valve Subjects. Five hundred and one individuals born in

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Low plasma concentrations of dobutamine resulted in an increase in CO almost solely due to improved left ventricular contractility. However, at higher plasma concentrations of dobutamine, SV remained stable or even decreased, and the linear increase in CO was entirely based on increased HR.

A time-dependent reduction of the aortic valve flow orifice can be demonstrated in persons representing the general elderly population. The deterioration of aortic valve function within a span of 3 years is neither clinically nor biochemically predictable. A longer follow-up may be necessary to identify the risk factors of aortic valve stenosis in old age.