چکیده :
BACKGROUND: Asymptomatic left ventricular systolic dysfunction is an important risk factor for heart
failure and death. Given the availability of patients, trained personnel, and equipment, the hospital is an
ideal setting to identify and initiate treatment for left ventricular systolic dysfunction. The purpose of this
study was to determine the prevalence of asymptomatic left ventricular systolic dysfunction in patients 45
years of age or older with at least one clinical heart failure risk factor admitted to a general medical service.
METHODS: Bedside, hand-carried echocardiography provided quantitative assessment of left ventricular systolic
function in 217 medical inpatients 45 years of age or older who had at least one heart failure risk factor. Patients
with known or suspected heart failure or with an assessment of left ventricular function in the past 5 years were
excluded. We measured the prevalence of asymptomatic left ventricular systolic dysfunction, defined by left
ventricular ejection fraction of 50% or lower, and its association with heart failure risk factors.
RESULTS: Of 207 patients with interpretable images, 11 (5.3%) had a left ventricular ejection fraction of
50% or lower. Patients with left ventricular systolic dysfunction had more heart failure risk factors than
those without left ventricular systolic dysfunction (3.090.8 vs 2.51.0, P.04). The total number of
heart failure risk factors trended towards an association with a greater prevalence of asymptomatic left
ventricular systolic dysfunction, but this did not reach significance (odds ratio 1.74; 95% confidence
interval, 0.97-3.12, P.06).
CONCLUSIONS: Asymptomatic left ventricular systolic dysfunction is present in about 1 of every 20 general
medical inpatients with at least one risk factor for heart failure. Because treatment of asymptomatic left
ventricular systolic dysfunction may reduce morbidity, further studies examining the costs and benefits of using
hand-carried ultrasound to identify this important condition in general medical inpatients are warranted
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