807-1 Congestive Heart Failure with Preserved Systolic Function in a Large Community-Dwelling Elderly Cohort: The Cardiovascular Health Study

Abstract

LV diastolic dysfunction is known to be an important cause of congestive heart failure (CHFI in the elderly. However, the prevalence of LV diastolic dysfunction as a mechanism of CHF in a large, elderly cohort is unknown. The Cardiovascular Health Study is an NHLBI sponsored multi-center study of community-dwelling individuals 65 years and older designed to evaluate cardiovascular risk, mortality and morbidity. In Year 2 (1989–90), 4,629 of 5,201 individuals successfully underwent two-dimensional echocardiography (2-D echo) evaluation of the left ventricle ILV). The table outlines the prevalence of definite CHF by history and LV systolic function as assessed by 2-D echo. Normal LV systolic function was defined as normal LV ejection fraction (EF) and wall motion by qualitative/semiquantitative assessment, abnormal was defined as presence of either abnormal EF or wall motion lakinesis/dyskinesis), and borderline was intermediate. Overall Men Women Total Studied by Echo 4,629 1,971 2,658 Definite CHF by History 79 (1.7%) 43 (2.2%) 36 (1.4%) Abnormal LV Systolic Function 31 (39%) 20 (46%) 11 (31%) Borderline LV Systolic Function 11 (14%) 5 (12%) 6 (17%) Normal LV Systolic Function 37 (47%) 18 (42%) 19 (53%) In this large elderly cohort; (1) the prevalence of definite congestive heart failure by history was 2%; 12) nearly one-half of participants with definite CHF had normal LV systolic function; (3) the distribution of systolic dysfunction among participants with definite CHF did not differ significantly by gender. These findings suggest a high prevalence of LV diastolic dysfunction as the mechanism of CHF among a large cohort of elderly, community-dwelling individuals.