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 follow-up. SETTING: University hospital. SUBJECTS: Five hundred and one individuals born in 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 lesion 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 disease (51%) were the main underlying conditions; 90% of patients had one or more of these diseases. Most individuals with CHF (28 of 39 patients, 72%) had normal left ventricular contractions at echocardiography. 'Diastolic CHF', defined as CHF with normal systolic left ventricular function and no regurgitant valve disease, was found in 51% (20 of 39 patients). The relative 4-year risk for death associated with CHF, adjusted for age and sex, was 2.1 (95% confidence interval 1.3-3.4) for all-cause mortality and 4.2 (CI 1.9-5.6) for cardiovascular mortality. CONCLUSIONS: The prevalence of CHF in a population aged 75-86 years is approximately 8%. Ischaemic or valvular heart disease and hypertension are the main underlying conditions. At echocardiography, about 50% of the elderly with CHF have normal left ventricular systolic contractions in the absence of valve disease and an additional 20% have normal systolic function with mitral regurgitation. The presence of CHF doubles the age- and sex-adjusted risk of death from all causes, and quadruples the risk of cardiovascular death during 4-year follow-up.
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 follow-up. SETTING: University hospital. SUBJECTS: Five hundred and one individuals born in 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 lesion 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 disease (51%) were the main underlying conditions; 90% of patients had one or more of these diseases. Most individuals with CHF (28 of 39 patients, 72%) had normal left ventricular contractions at echocardiography. 'Diastolic CHF', defined as CHF with normal systolic left ventricular function and no regurgitant valve disease, was found in 51% (20 of 39 patients). The relative 4-year risk for death associated with CHF, adjusted for age and sex, was 2.1 (95% confidence interval 1.3-3.4) for all-cause mortality and 4.2 (CI 1.9-5.6) for cardiovascular mortality. CONCLUSIONS: The prevalence of CHF in a population aged 75-86 years is approximately 8%. Ischaemic or valvular heart disease and hypertension are the main underlying conditions. At echocardiography, about 50% of the elderly with CHF have normal left ventricular systolic contractions in the absence of valve disease and an additional 20% have normal systolic function with mitral regurgitation. The presence of CHF doubles the age- and sex-adjusted risk of death from all causes, and quadruples the risk of cardiovascular death during 4-year follow-up.
Authors: M D Thomas; K F Fox; D A Wood; J S R Gibbs; A J S Coats; M Y Henein; P A Poole-Wilson; G C Sutton Journal: Heart Date: 2005-09-13 Impact factor: 5.994
Authors: Alexander M Clark; John J V McMurray; Caroline E Morrison; David L Murdoch; Simon Capewell; Margaret E Reid Journal: Pharm World Sci Date: 2005-12
Authors: Carolyn S P Lam; Peter E Carson; Inder S Anand; Thomas S Rector; Michael Kuskowski; Michel Komajda; Robert S McKelvie; John J McMurray; Michael R Zile; Barry M Massie; Dalane W Kitzman Journal: Circ Heart Fail Date: 2012-08-10 Impact factor: 8.790
Authors: David A Bluemke; Richard A Kronmal; João A C Lima; Kiang Liu; Jean Olson; Gregory L Burke; Aaron R Folsom Journal: J Am Coll Cardiol Date: 2008-12-16 Impact factor: 24.094