دانلود مقاله : Prevalence of Asymptomatic Left Ventricular Systolic Dysfunction in At-risk Medical

چکیده : 

BACKGROUND: Asymptomatic left ventricular systolic dysfunction is an important risk factor for heart

failure and death. Given the availability of patients, trained personnel, and equipment, the hospital is an

ideal setting to identify and initiate treatment for left ventricular systolic dysfunction. The purpose of this

study was to determine the prevalence of asymptomatic left ventricular systolic dysfunction in patients 45

years of age or older with at least one clinical heart failure risk factor admitted to a general medical service.

METHODS: Bedside, hand-carried echocardiography provided quantitative assessment of left ventricular systolic

function in 217 medical inpatients 45 years of age or older who had at least one heart failure risk factor. Patients

with known or suspected heart failure or with an assessment of left ventricular function in the past 5 years were

excluded. We measured the prevalence of asymptomatic left ventricular systolic dysfunction, defined by left

ventricular ejection fraction of 50% or lower, and its association with heart failure risk factors.

RESULTS: Of 207 patients with interpretable images, 11 (5.3%) had a left ventricular ejection fraction of

50% or lower. Patients with left ventricular systolic dysfunction had more heart failure risk factors than

those without left ventricular systolic dysfunction (3.090.8 vs 2.51.0, P.04). The total number of

heart failure risk factors trended towards an association with a greater prevalence of asymptomatic left

ventricular systolic dysfunction, but this did not reach significance (odds ratio 1.74; 95% confidence

interval, 0.97-3.12, P.06).

CONCLUSIONS: Asymptomatic left ventricular systolic dysfunction is present in about 1 of every 20 general

medical inpatients with at least one risk factor for heart failure. Because treatment of asymptomatic left

ventricular systolic dysfunction may reduce morbidity, further studies examining the costs and benefits of using

hand-carried ultrasound to identify this important condition in general medical inpatients are warranted