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European Heart Journal 2001 22(8):676-683; doi:10.1053/euhj.2000.2284
Copyright © 2001 by the European Society of Cardiology.
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Left ventricular systolic dysfunction in 75-year-old men and women. A population-based study

P Hedberga,f1, I Lönnbergb, T Jonasona, G Nilssonb, K Pehrssonc and I Ringqvistd

a Department of Clinical Physiology, Central Hospital, Västerås, Sweden
b Division of Cardiology, Department of Internal Medicine, Central Hospital, Västerås, Sweden
c Department of Cardiology, Karolinska Hospital, Stockholm, Sweden
d Centre of Clinical Research, University of Uppsala, Central Hospital, Västerås, Sweden

revised April 25, 2000; accepted May 15, 2000

Abstract

Aims To determine the prevalence of left ventricular systolic dysfunction in 75-year-old men and women.

Methods and Results In a population-based random sample of 75-year-old subjects (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 calculated as the mean value of the nine segments and (2) ejection fraction as measured by the disc summation method. Presence of heart failure was determined by a cardiologist's clinical evaluation. Wall motion index was achievable 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 the wall motion index (i.e. <1·7). In participants in whom both ejection fraction and wall motion index were achievable, wall motion index <1·7 predicted 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 the participants with left ventricular systolic dysfunction.

Conclusions Left ventricular systolic dysfunction is common among 75-year-olds 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 ventricular systolic dysfunction there is no clinical evidence of heart failure.

Key Words: Ventricular dysfunction, heart failure, prevalence, echocardiography, aged

f1 Correspondence: Dr Pär Hedberg, Department of Clinical Physiology, Central Hospital, S-721 89 Västers, Sweden.

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