Left ventricular systolic dysfunction in 75-year-old men and women - A population-based study

Aims To determine the prevalence of left ventricular systolic dysfunction i n 75-year-old men and women. Methods and Results In a population-based random sample of 75-year-old subj ects (n = 433; response rate 70.1%) the left ventricular systolic function was determined using two echocardiographic methods: (1) wall motion in nine left ventricular segments was visually scored and wall motion index was ca lculated as the mean value of the nine segments and (2) ejection fraction a s measured by the disc summation method. Presence of heart failure was dete rmined by a cardiologist's clinical evaluation. Wall motion index was achie vable in 95% of the participants while ejection fraction was measurable in 65%. Normal values were obtained from a healthy subgroup (n = 108) and left ventricular systolic dysfunction was defined as the 0.5th percentile of th e wall motion index (i.e. <1.7). In participants in whom both ejection frac tion and wall motion index were achievable, wall motion index <1.7 predicte d ejection fraction <43% with a sensitivity and specificity of 84.0% and 99 .6%, respectively. The prevalence of left ventricular systolic dysfunction was 6.8% (95% CI, 5.6-8.0%) and was greater in men than in women (10.2% vs 3.4%, P = 0.006). Clinical evidence of heart failure was absent in 46% of t he participants with left ventricular systolic dysfunction. Conclusions Left ventricular systolic dysfunction is common among 75-year-o lds with a prevalence of 6.8% in our estimate. The condition is more likely to affect men than women. In nearly half of 75-year-olds with left ventric ular systolic dysfunction there is no clinical evidence of heart failure.