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Titolo:
Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: The Cardiovascular Health Study
Autore:
Aurigemma, GP; Gottdiener, JS; Shemanski, L; Gardin, J; Kitzman, D;
Indirizzi:
Univ Massachusetts, Sch Med, Dept Med, Div Cardiol, Worcester, MA 01655 USA Univ Massachusetts Worcester MA USA 01655 ardiol, Worcester, MA 01655 USA St Francis Med Ctr, Div Cardiol, Roslyn, NY USA St Francis Med Ctr RoslynNY USA is Med Ctr, Div Cardiol, Roslyn, NY USA Univ Washington, Dept Biostat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Dept Biostat, Seattle, WA 98195 USA Univ Calif Irvine, Dept Med, Div Cardiol, Irvine, CA 92717 USA Univ Calif Irvine Irvine CA USA 92717 , Div Cardiol, Irvine, CA 92717 USA Wake Forest Univ, Bowman Gray Sch Med, Dept Med, Cardiol Sect, Winston Salem, NC 27103 USA Wake Forest Univ Winston Salem NC USA 27103 , Winston Salem, NC 27103 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 4, volume: 37, anno: 2001,
pagine: 1042 - 1048
SICI:
0735-1097(20010315)37:4<1042:PVOSAD>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; CORONARY-ARTERY DISEASE; ECHOCARDIOGRAPHIC MEASUREMENTS; MYOCARDIAL-INFARCTION; EJECTION FRACTION; HYPERTENSION; PREVALENCE; RISK; MASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Aurigemma, GP Univ Massachusetts, Sch Med, Dept Med, Div Cardiol, 55 Lake Ave N, Worcester, MA 01655 USA Univ Massachusetts 55 Lake Ave N Worcester MA USA 01655 USA
Citazione:
G.P. Aurigemma et al., "Predictive value of systolic and diastolic function for incident congestive heart failure in the elderly: The Cardiovascular Health Study", J AM COL C, 37(4), 2001, pp. 1042-1048

Abstract

OBJECTIVES We sought to assess the ability of echocardiographic indices ofsystolic and diastolic function to predict incident congestive heart failure (CHF). BACKGROUND Noninvasive indices of subclinical systolic and/or diastolic dysfunction that can be used to identify patients in a transition phase between normal cardiac function and clinical CI-IF would be valuable. Though midwall shortening and Doppler mitral inflow patterns are seemingly well suited to predict subsequent CHF, the predictive value of these indices has not been investigated. METHODS We studied 2,671 participants in the Cardiovascular Health Study who were free of coronary heart disease, CHF or atrial fibrillation. Clinical and quantitative echocardiographic data were obtained in all participants. RESULTS At a mean follow-up of 5.2 years (range 0 to 6 years), 170 participants (6.4% of the cohort) del eloped CHF. Although 96%, of these participants had normal or borderline ejection fraction (EF) at baseline, only 57% had normal or borderline EF at the time of hospitalization. In multivariate modeling, fractional shortening at the endocardium (relative risk [RR] 1.85per 10-unit decrease, confidence interval [CI] 1.27 to 2.39), fractional shortening at the midwall (RR 1.29 per five-unit decrease, 95% CI 1.11-1.51)and peak Doppler peak E (RR 1.15 for each 0.1 M/s increment; CI 1.02 to 1.21) independently, predicted incident CHF. Both high and low Doppler E/A ratios were predictive of incident CHF. CONCLUSIONS Roughly half the occurrences of CI-IF in this population are associated with normal or borderline EF. Echocardiographic findings suggestive of subclinical contractile dysfunction and diastolic filling abnormalities are both predictive of subsequent CI-IF. The standard (FSendo) and refined (FSmw) parameters of systolic function performed similarly in this regard, though subjects with left ventricular hypertrophy and depressed FSmw areat particularly high risk for subsequent CHF. (J Am Coll Cardiol 2001;37:1042-8) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 15:49:09