Systolic and Diastolic Heart Failure in the Community

Abstract

In the community, more than half of patients with HF have preserved EF, and isolated diastolic dysfunction is present in more than 40% of cases. Ejection fraction and diastolic dysfunction are independently related to higher levels of BNP. Heart failure with preserved EF is associated with a high mortality rate, comparable to that of patients with reduced EF.

Prevalence and Prognosis of Asymptomatic Left Ventricular Diastolic Dysfunction in Ambulatory Patients With Coronary Heart Disease

“…The increased risk of cardiovascular events associated with asymptomatic LV diastolic dysfunction was similar to that observed for patients with known HF. 2 Our results highlight the importance of asymptomatic LV diastolic dysfunction and raise the possibility that patients with LV diastolic dysfunction may benefit from more aggressive therapy to prevent or delay the development of clinical HF.…”

“…5 Administrative databases were used to identify outpatients with documented coronary artery disease at 2 Department of Veterans Affairs medical center databases (San Francisco and Palo Alto, California), 1 university-based medical center (University of California Medical Center-San Francisco), and 9 public health clinics in the Community Health Network of San Francisco, California. Criteria for enrollment included 1 of (1) history of myocardial infarction, (2) angiographic evidence of ≥50% stenosis in ≥1 coronary vessel, (3) previous evidence of exercise-induced ischemia using treadmill electrocardiogram or stress nuclear perfusion imaging, or (4) history of coronary revascularization. Patients were excluded if they deemed themselves unable to walk 1 block, experienced an acute coronary syndrome in the previous 6 months, or were planning to move out of the local area within 3 years.…”

“…[1][2][3] The prevalence and prognosis of asymptomatic LV diastolic dysfunction is unclear because most studies of the association between LV diastolic dysfunction and adverse outcomes examined patients with clinical HF. 1-3 One previous study examined the association of LV diastolic dysfunction with cardiovascular outcomes in patients without known heart disease, 4 but the prevalence and *Corresponding author: Tel.…”

Change in Comorbidity Prevalence with Advancing Age Among Persons with Heart Failure

“…We were unable to distinguish between systolic and diastolic heart failure using the CCW data set. As the proportion of diastolic versus systolic heart failure increases with increasing age [39][40][41] , it is possible that comorbidity profiles might also differ according to the type of heart failure. Finally, because we focused on Medicare beneficiaries >65 years of age and excluded beneficiaries enrolled for any period of time in managed care, our findings may not be generalizable to the larger Medicare population.…”

Effect of the long-term administration of nebivolol on clinical symptoms, exercise capacity and left ventricular function in patients with heart failure and preserved left ventricular ejection fraction: background, aims and design of the ELANDD study

“…Approximately 40-60% of patients with HF have a normal or nearly normal left ventricular (LV) ejection fraction (EF) and the main cause of their symptoms and clinical course is LV diastolic dysfunction [1,2]. These patients may have abnormalities of other indexes of LV systolic function, despite a preserved LVEF.…”