Rb. Devereux et al., A population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study, AM HEART J, 141(3), 2001, pp. 439-446
Citations number
32
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background Although clinical congestive heart failure (CHF) is increasingly
common, few data document the prevalence and correlates of underlying left
ventricular (IV) systolic dysfunction (D) in population-based samples.
Methods Echocardiography was used in the second Strong Heart Study (SHS) ex
amination to identify mild and severe LVD (LV ejection fraction [EF] 40%-54
% and <40%, respectively) in 3184 American Indians.
Results Mild and severe LVD were more common in men than women (17.4% vs 7.
2% and 4.7% vs 1.8%) and in diabetic than nondiabetic participants (12.7% v
s 9.1% and 3.5% vs 1.6%). Stepwise increases were observed from participant
s with normal EF to those with mild and severe LVD in age (mean 60 vs 61 an
d 63 years, P<.001), prevalence of overt CHF (2% vs 6% and 28%) and definit
e coronary heart disease (3% vs 11% and 32%), systolic pressure (129 vs 135
and 136 mm Hg), serum creatinine level (0.98 vs 1.34 and 2.16 mg/dL), and
log urinary albumin/creatinine level (3.2 vs 3.7 and 4.7); a negative relat
ion was seen with body moss index (31.1 vs 31.0 and 28.4 kg/m(2)) (all P<.0
01), In multivariate analyses lower LVEFs were independently associated wit
h clinical CHF and coronary heart disease, lower myocardial contractility,
male sex, hypertension, overweight, arterial stiffening (higher pulse press
ure/stroke volume) and renal dysfunction (higher serum creatinine level), h
igher LV mass, and lower relative wall thickness.
Conclusions LVD, present in approximately 14% of middle-aged to elderly adu
lts, is independently associated with overt heart failure and coronary hear
t disease, male sex, hypertension, overweight, arterial stiffening, and ren
al target organ damage and, less consistently, with older age and diabetes.