Clinical syndrome suggestive of heart failure is frequently attributable to non-cardiac disorders - population-based study

被引:25
作者
Azevedo, Ana
Bettencourt, Paulo
Pimenta, Joana
Frioes, Fernando
Abreu-Lima, Cassiano
Hense, Hans-Werner
Barros, Henrique
机构
[1] Univ Porto, Sch Med, Dept Hyg & Epidemiol, P-4200319 Oporto, Portugal
[2] Hosp Sao Joao, Dept Internal Med, Heart Failure Clin, Oporto, Portugal
[3] Hosp Sao Joao, Dept Cardiol, Oporto, Portugal
[4] Univ Munster, Inst Epidemiol & Social Med, Munster, Germany
关键词
heart failure; diagnosis; preserved systolic function; diastolic heart failure; population-based study; symptoms;
D O I
10.1016/j.ejheart.2006.10.017
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: 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. (c) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:391 / 396
页数:6
相关论文
共 23 条
[1]   Population based study on the prevalence of the stages of heart failure [J].
Azevedo, A. ;
Bettencourt, P. ;
Dias, P. ;
Abreu-Lima, C. ;
Hense, H-W ;
Barros, H. .
HEART, 2006, 92 (08) :1161-1163
[2]   AN INVENTORY FOR MEASURING DEPRESSION [J].
BECK, AT ;
ERBAUGH, J ;
WARD, CH ;
MOCK, J ;
MENDELSOHN, M .
ARCHIVES OF GENERAL PSYCHIATRY, 1961, 4 (06) :561-&
[3]   Diagnosing primary diastolic heart failure [J].
Brutsaert, DL .
EUROPEAN HEART JOURNAL, 2000, 21 (02) :94-96
[4]   ESTIMATING THE POPULATION ATTRIBUTABLE RISK FOR MULTIPLE RISK-FACTORS USING CASE-CONTROL DATA [J].
BRUZZI, P ;
GREEN, SB ;
BYAR, DP ;
BRINTON, LA ;
SCHAIRER, C .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1985, 122 (05) :904-913
[5]   Do patients with suspected heart failure and preserved left ventricular systolic function suffer from "diastolic heart failure" or from misdiagnosis? A prospective descriptive study [J].
Caruana, L ;
Petrie, MC ;
Davie, AP ;
McMurray, JJV .
BRITISH MEDICAL JOURNAL, 2000, 321 (7255) :215-218
[6]   PREDICTION OF CREATININE CLEARANCE FROM SERUM CREATININE [J].
COCKCROFT, DW ;
GAULT, MH .
NEPHRON, 1976, 16 (01) :31-41
[7]   ECHOCARDIOGRAPHIC DETERMINATION OF LEFT-VENTRICULAR MASS IN MAN - ANATOMIC VALIDATION OF METHOD [J].
DEVEREUX, RB ;
REICHEK, N .
CIRCULATION, 1977, 55 (04) :613-618
[8]   Barriers to accurate diagnosis and effective management of heart failure in primary care: qualitative study [J].
Fuat, A ;
Pali, A ;
Hungin, S ;
Murphy, JJ .
BMJ-BRITISH MEDICAL JOURNAL, 2003, 326 (7382) :196-200
[9]  
Hunt Sharon Ann, 2005, J Am Coll Cardiol, V46, pe1, DOI 10.1016/j.jacc.2005.08.022
[10]   Distribution, determinants and reference values of left ventricular parameters in the general population -: Results of the MONICA/KORA echocardiography studies [J].
Kuch, B ;
Schunkert, H ;
Muscholl, M ;
Döring, A ;
von Scheidt, W ;
Hense, HW .
GESUNDHEITSWESEN, 2005, 67 :S68-S73