title: Prevalence of left ventricular dysfunction in a UK community sample of very old people: the Newcastle 85+ study.
abstract: OBJECTIVE
  Heart failure (HF) prevalence rises sharply among those aged 85 years and over. Previous population based echocardiographic studies of left ventricular (LV) dysfunction, the substrate for HF, have included only small numbers in this age group. We used domiciliary echocardiography to estimate the prevalence of LV systolic and diastolic dysfunction in 87-89 year olds and the proportion remaining undiagnosed.
  
  
  METHODS
  Cross sectional analysis of data from Newcastle 85+ Study.
  
  
  METHODS
  Primary care, North-East England.
  
  
  METHODS
  376 men and women aged 87-89 years.
  
  
  METHODS
  Domiciliary echocardiography was performed and LV systolic and diastolic function was graded. The presence of limiting dyspnoea was assessed by questionnaire. Previous diagnoses of HF were abstracted from general practice (GP) records.
  
  
  RESULTS
  32% of participants (119/376) had LV systolic dysfunction (ejection fraction (EF) ≤50%) and a further 20% (75/376) had moderate or severe LV diastolic dysfunction with preserved EF. Both echocardiographic assessment of LV function and dyspnoea status were available in 74% (278/376) of participants. Among these participants, limiting dyspnoea was present in approximately two thirds of those with significant (systolic or isolated moderate/severe diastolic) LV dysfunction. 84% (73/87) of participants with significant LV dysfunction and limiting dyspnoea did not have a pre-existing HF diagnosis in their GP records. Overall, 26% (73/278) of participants with both echocardiographic and dyspnoea data had undiagnosed, symptomatic, significant LV dysfunction.
  
  
  CONCLUSIONS
  Significant systolic and diastolic LV dysfunction is much commoner in community dwelling 87-89 year olds than previous studies have suggested. The majority are both symptomatic and undiagnosed.
authors.affiliation: Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
authors.forename: Fahad
authors.initials: F
authors.lastname: Yousaf
authors.forename: Joanna
authors.initials: J
authors.lastname: Collerton
authors.forename: Andrew
authors.initials: A
authors.lastname: Kingston
authors.forename: Antoinette
authors.initials: A
authors.lastname: Kenny
authors.forename: Karen
authors.initials: K
authors.lastname: Davies
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Louise
authors.initials: L
authors.lastname: Robinson
authors.forename: Thomas B L
authors.initials: TB
authors.lastname: Kirkwood
authors.forename: Bernard
authors.initials: B
authors.lastname: Keavney
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003971:Diastole; D004417:Dyspnea / Q000453:epidemiology; D015150:Echocardiography, Doppler; D004739:England / Q000453:epidemiology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D016277:Ventricular Function, Left