Echocardiography Should Be Performed in All Elderly Patients with Congestive Heart Failure*

Aronow, Wilbert S.

doi:10.1111/j.1532-5415.1994.tb06516.x

Cited by 46 publications

(14 citation statements)

References 21 publications

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“…By increasing contractility through increased intracellular calcium concentration, digoxin may increase LV stiffness in these patients, increasing LV filling pressure and aggravating HF associated with normal LV ejection fraction. 119,120 At 37-month follow up of 7788 patients, mean age 64 years, with HF (6800 with a LV ejection fraction Յ45% and 988 with a LV ejection fraction Ͼ45%) in the Digitalis Investigator Group (DIG) study, mortality was similar in patients treated with digoxin or placebo in patients with low or normal LV ejection fraction. 121,122 HF hospitalization was significantly reduced 28% in patients with a low LV ejection fraction and insignificantly reduced 21% in patients with a LV ejection fraction Ͼ45%.…”

Section: Digoxinmentioning

confidence: 97%

Epidemiology, Pathophysiology, Prognosis, and Treatment of Systolic and Diastolic Heart Failure

Aronow

2006

Cardiology in Review

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109

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Underlying causes, risk factors, and precipitating causes of heart failure (HF) should be treated. Drugs known to precipitate or aggravate HF such as nonsteroidal antiinflammatory drugs should be stopped. Patients with HF and a low left ventricular ejection fraction (systolic heart failure) or normal ejection fraction (diastolic HF) should be treated with diuretics if fluid retention is present, with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker if the patient cannot tolerate an ACE inhibitor because of cough, angioneurotic edema, rash, or altered taste sensation, and with a beta blocker unless contraindicated. If severe systolic HF persists, an aldosterone antagonist should be added. If HF persists, isosorbide dinitrate plus hydralazine should be added. Calcium channel blockers should be avoided if systolic HF is present. Digoxin should be avoided in men and women with diastolic HF if sinus rhythm is present and in women with systolic HF. Digoxin should be given to men with systolic HF if symptoms persist, but the serum digoxin level should be maintained between 0.5 and 0.8 ng/mL.

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Section: Digoxinmentioning

confidence: 97%

Epidemiology, Pathophysiology, Prognosis, and Treatment of Systolic and Diastolic Heart Failure

Aronow

2006

Cardiology in Review

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109

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“…Echocardiography, the most commonly used modality, provides information regarding left ventricular thickness and function, valvular disease, chamber size, pulmonary arterial pressure, and pericardial disease, all of which are critical in determining optimal management [ 23 ]. Newer serum-based assessments of brain natriuretic peptide (BNP) assays provide sensitive detection of HF LVSD and HF PEF [ 24 ].…”

Section: Diagnosismentioning

confidence: 99%

Heart failure in older adults

Forman

2008

Curr Cardio Risk Rep

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Typical aging leads to insidious changes in the heart and throughout the body that predispose to heart failure (HF). HF with left ventricular systolic dysfunction and HF with preserved ejection fraction increase as a result of common age-related physiologic changes. Moreover, aging is associated with high comorbidity and high likelihood of iatrogenic side effects from therapeutic interventions that add to the complexity of HF management and contribute to patterns of particularly high HF mortality and morbidity. This article reviews key age-related mechanisms of HF pathophysiology and associated management challenges.

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“…C H F was diagnosed if two crite ria were satisfied: (1) pu lmonary basilar rates we re heard by two physicians, including the senio r autho r; and (2) pu lmonary vascular congestio n was prese nt on th e chest radiographs interpreted by both an expe rienced radiologist and th e senior au thor.…”

Section: Aterial S and M Ethodsmentioning

confidence: 99%

Normal Left Ventricular Ejection Fraction in Older Persons With Congestive Heart Failure

Aronow

Ahn

Kronzon

1998

Chest

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Echocardiography Should Be Performed in All Elderly Patients with Congestive Heart Failure*

Cited by 46 publications

References 21 publications

Epidemiology, Pathophysiology, Prognosis, and Treatment of Systolic and Diastolic Heart Failure

Epidemiology, Pathophysiology, Prognosis, and Treatment of Systolic and Diastolic Heart Failure

Heart failure in older adults

Normal Left Ventricular Ejection Fraction in Older Persons With Congestive Heart Failure

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