title: Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: the INDYCE registry.
abstract: BACKGROUND
  The distribution of left ventricular ejection fraction (LVEF) - a key factor in coronary artery disease (CAD) patient management and prognostication - is poorly documented.
  
  
  OBJECTIVE
  To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France.
  
  
  METHODS
  The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded.
  
  
  RESULTS
  Overall, 3119 patients (68.4 +/- 11.0 years; 80% men) were enrolled. LVEF was 56.1+/-11.8% on average, and was poor (<40%) and moderately impaired (40-50%) in 9.6% (n=298) and 19.8% (n=619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class < or = I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59-5.63; P<0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration.
  
  
  CONCLUSIONS
  Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR>or=70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.
authors.affiliation: Les Grands Prés, 77174 Villeneuve Saint-Denis, France. jtabet@free.fr
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Tabet
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Malergue
authors.forename: Maxime
authors.initials: M
authors.lastname: Guenoun
authors.forename: Franck
authors.initials: F
authors.lastname: Paganelli
authors.forename: Philippe
authors.initials: P
authors.lastname: Meurin
authors.forename: Didier
authors.initials: D
authors.lastname: Not
authors.forename: Patrick
authors.initials: P
authors.lastname: Jourdain
authors.forename: Dominique
authors.initials: D
authors.lastname: Guedj-Meynier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002317:Cardiovascular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006339:Heart Rate; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012042:Registries; D013318:Stroke Volume; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left
chemical_list: D002317:Cardiovascular Agents