- 作者：Ana Azevedo ; Paulo Bettencourt ; Joana Pimenta ; Fern ; o Friõ ; es ; Cassiano Abreu-Lima ; Hans-Werner Hense ; Henrique Barros
- 关键词：Heart failure ; Diagnosis ; Preserved systolic function ; Diastolic heart failure ; Population-based study ; Symptoms
- 刊名：European Journal of Heart Failure
- 出版年：2007
- 出版时间：April 2007
- 年：2007
- 卷：9
- 期：4
- 页码：391-396
- 全文大小：125 K
To assess how often the clinical syndrome (CS) of heart failure is attributable to alternative, including non-cardiac, explanations.
Methods and results
Cross-sectional evaluation of 739 community participants aged ≥ 45 years. Subjects with ≥ 2 symptoms or signs (dyspnoea or fatigue, orthopnoea, nocturnal paroxysmal dyspnoea, third heart sound, jugular venous distension, rales and lower limb oedema) or who were receiving loop diuretics were considered to have the clinical syndrome of heart failure. Attributable fractions were derived based on adjusted odds ratios and the prevalence of underlying disorders among cases. CS was present in 28.0 % of women and in 15.2 % of men, p < 0.001. The multivariate-adjusted fraction of CS attributable to female gender was 40.6 % , to age ≥ 65 years 28.5 % , left ventricular systolic dysfunction, left ventricular dilatation or moderate–severe valvular disease 4.9 % , diastolic dysfunction or atrial fibrillation 13.0 % , obesity 22.6 % , coronary heart disease 7.2 % and chronic lung disease 6.9 % . When additionally adjusting for depressive symptoms, the association with gender and age became much weaker, and 32 % of cases were attributable to depressive symptoms. Forty-two percent of subjects with CS had cardiac abnormalities.
Conclusion
In less than half of subjects with CS was systolic or diastolic heart failure confirmed. Female gender, older age, obesity and depressive symptoms accounted for the largest fraction of CS.