Cross sectional study estimating prevalence of heart failure and left ventricular systolic dysfunction in community patients at risk.
OBJECTIVE
To examine a general practice population to measure the prevalence of signs and symptoms of heart failure (SSHF) and left ventricular systolic dysfunction (LVSD).


METHODS
Cross sectional screening study in three general practices followed by echocardiography.


METHODS
All patients >/= 50 years in two general practices and >/= 40 years in one general practice were screened by case record reviews and questionnaires (n = 2158), to identify subjects with some evidence of heart disease. Among these, subjects were sought who had SSHF (n = 115). Of 357 subjects with evidence of heart disease, 252 were eligible for examination, and 126 underwent further cardiological assessment, including 43 with SSHF.


METHODS
Prevalence of SSHF as defined by a modified Boston index, LVSD defined as an indirectly measured left ventricular ejection fraction </= 0.45, and numbers of subjects needing an echocardiogram to detect one case with LVSD.


RESULTS
SSHF afflicted 0.5% of quadragenarians and rose to 11.7% of octogenarians. Two thirds were handled in primary care only. At >/= 50 years of age 6.4% had SSHF, 2.9% had LVSD, and 1.9% (95% confidence interval 1.3% to 2.5%) had both. To detect one case with LVSD in primary care, 14 patients with evidence of heart disease without SSHF and 5.5 patients with SSHF had to be examined.


CONCLUSIONS
SSHF is extremely prevalent in the community, especially in primary care, but more than two thirds do not have LVSD. The number of subjects with some evidence of heart disease needing an echocardiogram to detect one case of LVSD is 14.
Nielsen
O W
OW
Cardiovascular Department, Copenhagen University Hospital, DK-2650 Hvidovre, Denmark. own@dadlnet.dk
Hilden
J
J
Larsen
C T
CT
Hansen
J F
JF
D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003625:Data Collection; D003718:Denmark / Q000453:epidemiology; D004452:Echocardiography; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology*