 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
3 June 2003 | Volume 138 Issue 11 | Pages 907-916
Congestive heart failure is a progressive disorder that is frequently preceded by asymptomatic left ventricular systolic dysfunction. We reviewed the epidemiology, diagnosis, and natural history of asymptomatic left ventricular systolic dysfunction and evaluated community-wide screening for this condition as a potential strategy to reduce the incidence of heart failure. Asymptomatic left ventricular systolic dysfunction has an estimated prevalence of 3% to 6%, and is at least as common in the community as systolic heart failure. Because it often occurs in the absence of known cardiovascular disease, this condition may go unrecognized and undertreated. In randomized trials, individuals with asymptomatic left ventricular systolic dysfunction have high rates of incident heart failure and death. However, little is known about the prognosis of individuals with this condition in the community, who have a substantially lower prevalence of myocardial infarction, have milder degrees of systolic dysfunction, and are older than patients enrolled in clinical trials. Current evidence is inadequate to support community-wide screening for asymptomatic left ventricular systolic dysfunction, either with echocardiography or with assays for natriuretic peptides. Given the increasing prevalence of heart failure, additional studies are needed to develop effective strategies to detect and optimally manage individuals with asymptomatic left ventricular dysfunction in the community.
Author and Article Information
From the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts; Massachusetts General Hospital, Harvard Medical School, Boston Medical Center, and Boston University School of Medicine, Boston, Massachusetts; and the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
Acknowledgments: The authors thank Moira Pryde for administrative and research assistance with this manuscript.
Grant Support: By National Institutes of Health, National Heart, Lung, and Blood Institute grants 1U01-HL-66582 and K24 HL-04334-01A1 and contract N01-HC-25195. Dr. Wang is a recipient of an American College of Cardiology/Merck Adult Cardiology Fellowship Award.
Potential Financial Conflicts of Interest:Grants received: T.J. Wang (American College of Cardiology and Merck Pharmaceuticals).
Requests for Single Reprints: Ramachandran S. Vasan, MD, Framingham Heart Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA 01702-5827; e-mail, vasan{at}fram.nhlbi.nih.gov.
Current Author Addresses: Drs. Wang, Levy, Benjamin, and Vasan: Framingham Heart Study, 73 Mt. Wayte Avenue, Suite 2, Framingham, MA 01702-5827. REVIEW
The Epidemiology of "Asymptomatic" Left Ventricular Systolic Dysfunction: Implications for Screening
Note added in proof: Two important studies were published after the submission of our manuscript. Redfield and colleagues (81) recently published the full report of their Doppler echocardiographic survey of 2042 residents of Olmsted County, Minnesota. Among participants without CHF, 20.6% had mild diastolic dysfunction and 6.8% had moderate or severe diastolic dysfunction. Individuals with diastolic dysfunction had a higher mortality after adjustment for age, sex, and ejection fraction. In another recent study, Nielsen and colleagues (82) estimated the cost-effectiveness of brain natriuretic peptide for screening for LVSD, based on data from the Glasgow MONICA survey.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  J. N. Kirkpatrick, S. N. Ghani, and K. T. Spencer Hand carried echocardiography screening for LV systolic dysfunction in a pulmonary function laboratory Eur J Echocardiogr, May 1, 2008; 9(3): 381 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Mahadevan, R C Davis, M P Frenneaux, F D R Hobbs, G Y H Lip, J E Sanderson, and M K Davies Left ventricular ejection fraction: are the revised cut-off points for defining systolic dysfunction sufficiently evidence based? Heart, April 1, 2008; 94(4): 426 - 428. [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Shankar, N. Marina, M. M. Hudson, D. C. Hodgson, M. J. Adams, W. Landier, S. Bhatia, K. Meeske, M. H. Chen, K. E. Kinahan, et al. Monitoring for Cardiovascular Disease in Survivors of Childhood Cancer: Report From the Cardiovascular Disease Task Force of the Children's Oncology Group Pediatrics, February 1, 2008; 121(2): e387 - e396. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Bierig, A. Ryan, A. Ziaee, L. Kociolek, J. Simon, S. Herrmann, and A. J. Labovitz Serial changes in systolic and diastolic echocardiographic indices as predictors of outcome in patients with decreased left ventricular ejection fraction Eur J Echocardiogr, October 1, 2007; 8(5): 369 - 374. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. C. Costello-Boerrigter, G. Boerrigter, G. J. Harty, A. Cataliotti, M. M. Redfield, and J. C. Burnett Jr Mineralocorticoid Escape by the Kidney But Not the Heart in Experimental Asymptomatic Left Ventricular Dysfunction Hypertension, September 1, 2007; 50(3): 481 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Aspromonte, V. Ceci, A. Chiera, C. Coletta, A. D'Eri, M. Feola, P. Giovinazzo, L. Milani, F. Noventa, A. B. Scardovi, et al. Rapid Brain Natriuretic Peptide Test and Doppler Echocardiography for Early Diagnosis of Mild Heart Failure Clin. Chem., September 1, 2006; 52(9): 1802 - 1808. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Hays, R. L. Sacco, T. Rundek, R. R. Sciacca, Z. Jin, R. Liu, S. Homma, and M. R. Di Tullio Left Ventricular Systolic Dysfunction and the Risk of Ischemic Stroke in a Multiethnic Population Stroke, July 1, 2006; 37(7): 1715 - 1719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. R. Goldberg and M. Jessup Stage B Heart Failure: Management of Asymptomatic Left Ventricular Systolic Dysfunction Circulation, June 20, 2006; 113(24): 2851 - 2860. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Zoccali, F. A. Benedetto, G. Tripepi, F. Mallamaci, F. Rapisarda, G. Seminara, G. Bonanno, and L. S. Malatino Left Ventricular Systolic Function Monitoring in Asymptomatic Dialysis Patients: A Prospective Cohort Study J. Am. Soc. Nephrol., May 1, 2006; 17(5): 1460 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Bhatia, M. D. Sosin, J. V. Patel, K. A. Grindulis, F. H. Khattak, E. A. Hughes, G. Y.H. Lip, and R. C. Davis Left Ventricular Systolic Dysfunction in Rheumatoid Disease: An Unrecognized Burden? J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1169 - 1174. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Wali, G. S. Wang, S. S. Gottlieb, L. Bellumkonda, R. Hansalia, E. Ramos, C. Drachenberg, J. Papadimitriou, M. A. Brisco, S. Blahut, et al. Effect of kidney transplantation on left ventricular systolic dysfunction and congestive heart failure in patients with end-stage renal disease J. Am. Coll. Cardiol., April 5, 2005; 45(7): 1051 - 1060. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Gluud and L. L. Gluud Evidence based diagnostics BMJ, March 26, 2005; 330(7493): 724 - 726. [Full Text] [PDF]
|
|
|
|
|
|
P. Verdecchia, F. Angeli, R. Gattobigio, M. Sardone, and C. Porcellati Asymptomatic Left Ventricular Systolic Dysfunction in Essential Hypertension: Prevalence, Determinants, and Prognostic Value Hypertension, March 1, 2005; 45(3): 412 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Bihan, C. Espinosa, H. Valdes-Socin, S. Salenave, J. Young, S. Levasseur, P. Assayag, A. Beckers, and P. Chanson Long-Term Outcome of Patients with Acromegaly and Congestive Heart Failure J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5308 - 5313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Redfield, R. J. Rodeheffer, S. J. Jacobsen, D. W. Mahoney, K. R. Bailey, and J. C. Burnett Jr Plasma Brain Natriuretic Peptide to Detect Preclinical Ventricular Systolic or Diastolic Dysfunction: A Community-Based Study Circulation, June 29, 2004; 109(25): 3176 - 3181. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Hequet, Q.H. Le, I. Moullet, E. Pauli, G. Salles, D. Espinouse, C. Dumontet, C. Thieblemont, P. Arnaud, D. Antal, et al. Subclinical Late Cardiomyopathy After Doxorubicin Therapy for Lymphoma in Adults J. Clin. Oncol., May 15, 2004; 22(10): 1864 - 1871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Zoccali, F. A. Benedetto, F. Mallamaci, G. Tripepi, G. Giacone, A. Cataliotti, G. Seminara, B. Stancanelli, and L. S. Malatino Prognostic Value of Echocardiographic Indicators of Left Ventricular Systolic Function in Asymptomatic Dialysis Patients J. Am. Soc. Nephrol., April 1, 2004; 15(4): 1029 - 1037. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Wang, M. G. Larson, D. Levy, E. J. Benjamin, E. P. Leip, T. Omland, P. A. Wolf, and R. S. Vasan Plasma Natriuretic Peptide Levels and the Risk of Cardiovascular Events and Death N. Engl. J. Med., February 12, 2004; 350(7): 655 - 663. [Abstract] [Full Text] [PDF]
|
|
Article
