title: The prognostic value of the physical examination in patients with chronic heart failure.
abstract: The importance placed on the physical examination in the assessment of patients with cardiovascular disorders appears to be declining, perhaps in part due to a paucity of data showing its value in the modern era. To determine whether the physical examination provides important prognostic information in patients with chronic heart failure, the authors performed a post-hoc analysis of 2479 participants from the Studies of Left Ventricular Dysfunction (SOLVD) treatment trial. The presence of elevated jugular venous pressure and a third heart sound at baseline were each associated with subsequent heart failure hospitalization, the composite end point of death or heart failure hospitalization, and pump-failure death, independently of many other markers of disease severity. The subgroup of patients with at least one of these two physical examination findings was at increased risk for all-cause mortality. The authors believe that additional studies assessing the prognostic value of the physical examination should be conducted and, if favorable, likely would lead to a renewed interest in the physical examination.
authors.affiliation: Heart Failure Research Unit, Donald W. Reynolds Cardiovascular Clinical Research Center, University of texas Southwestern Medical Center, Dallas, TX 75390-9047, USA.
authors.forename: J Eduardo
authors.initials: JE
authors.lastname: Rame
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Dries
authors.forename: Mark H
authors.initials: MH
authors.lastname: Drazner
mesh_terms: D002302:Cardiac Output; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D006347:Heart Sounds; D006439:Hemodynamics; D006801:Humans; D015999:Multivariate Analysis; D010808:Physical Examination; D011379:Prognosis; D014636:Valsalva Maneuver