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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
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Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism

Published on: September 1, 2014

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Natural history of asymptomatic left ventricular systolic dysfunction in the community

Thomas J Wang1, Jane C Evans, Emelia J Benjamin

  • 1Framingham Heart Study, Framingham, MA 01702-5827, USA.

Circulation
|August 13, 2003
PubMed

Insights

Individuals with asymptomatic left ventricular systolic dysfunction (ALVD) face a significantly higher risk of developing congestive heart failure (CHF) and death. This risk is present even with mild impairment, highlighting the need for further research into optimal treatments.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Clinical Research

Background:

  • Limited data exists on the progression rates of congestive heart failure (CHF) and mortality in individuals with asymptomatic left ventricular systolic dysfunction (ALVD).
  • Characterizing the natural history of ALVD in community-dwelling individuals is crucial for understanding disease progression and outcomes.

Purpose of the Study:

  • To investigate the natural history of asymptomatic left ventricular systolic dysfunction (ALVD).
  • To determine the rates of progression to congestive heart failure (CHF) and death in individuals with ALVD.

Main Methods:

  • Analysis of 4257 participants from the Framingham Study undergoing routine echocardiography.
  • Assessment of asymptomatic left ventricular systolic dysfunction (ALVD) defined as ejection fraction (EF) ≤50% without a history of CHF.
  • Longitudinal follow-up for up to 12 years to track rates of CHF and mortality.

Main Results:

  • Prevalence of ALVD was 6.0% in men and 0.8% in women. CHF rates were 5.8 per 100 person-years in ALVD subjects versus 0.7 in normal subjects.
  • ALVD was associated with a 4.7-fold increased risk of CHF (adjusted HR 4.7) and a 1.6-fold increased risk of mortality (adjusted HR 1.6).
  • Even mild ALVD (EF 40-50%) showed a 3.3-fold increased risk of CHF, and moderate-to-severe ALVD (EF <40%) showed a 7.8-fold increased risk.

Conclusions:

  • Asymptomatic left ventricular systolic dysfunction (ALVD) significantly elevates the risk of congestive heart failure (CHF) and mortality in the community.
  • The increased risk is evident even with mild reductions in ejection fraction (EF).
  • Further research is necessary to establish optimal therapeutic strategies for individuals with mild ALVD.
Abstract

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