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Left ventricular function in hospitalized geriatric patients

R J Luchi, E Snow, J M Luchi

    Journal of the American Geriatrics Society
    |November 1, 1982
    PubMed
    Summary
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    In older adults (75+), a left ventricular ejection fraction below 0.50 may indicate heart disease. Congestive heart failure in this group often involves diastolic dysfunction, with a favorable short-term prognosis.

    Area of Science:

    • Cardiology
    • Geriatrics
    • Internal Medicine

    Background:

    • Left ventricular ejection fraction (LVEF) assessment is crucial in geriatric patients.
    • Heart failure diagnosis and management in the elderly present unique challenges.
    • The role of diastolic dysfunction in heart failure among older adults requires further investigation.

    Purpose of the Study:

    • To evaluate left ventricular ejection fraction in elderly patients (75+) admitted to a Geriatric Acute Assessment Ward.
    • To determine the correlation between LVEF, clinically identifiable heart disease, and congestive heart failure in this population.
    • To propose a lower limit for normal LVEF in individuals aged 75 and older.

    Main Methods:

    • Gated wall motion imaging was used to measure LVEF in 62 patients aged 75 years and older.

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  • Analysis focused on 42 patients not receiving cardioactive medications.
  • Patients were categorized into groups with and without clinically identifiable heart disease.

    • Main Results:

    • Patients without heart disease had a mean LVEF of 0.60 +/- 0.09; none were below 0.50.
    • Patients with heart disease had a mean LVEF of 0.49 +/- 0.15 (P < 0.01), correlated with cardiac enlargement or heart failure.
    • 58% of heart failure patients had LVEF >= 0.40, suggesting frequent diastolic dysfunction.

    Conclusions:

    • A lower limit of LVEF of 0.50 is proposed for patients 75 years and older.
    • Congestive heart failure in this age group is often associated with preserved or normal LVEF, indicating diastolic dysfunction.
    • Digitalis may not be indicated in these cases, and the short-term prognosis is relatively favorable.