Circulation, Vol 77, 607-612, Copyright © 1988 by American Heart Association
PR Marantz, JN Tobin, S Wassertheil-Smoller, RM Steingart, JP Wexler, N Budner, L Lense and J Wachspress
There is no uniformly accepted clinical definition for congestive heart
failure (CHF), although criteria have been published by various groups.
There is also no reference standard for CHF, although left ventricular
ejection fraction (LVEF) gives a quantitative assessment of systolic
function and is useful in predicting prognosis. To determine the
relationship between LVEF and clinically diagnosed CHF, we compared resting
LVEF determined by radionuclide ventriculography with diagnosis of CHF by
clinical criteria in 407 patients, based on clinical data collected by a
cardiology fellow. Of 153 patients with a low LVEF (less than or equal to
0.40), 30 (20%) met none of the criteria for CHF. Conversely, of 204
patients with normal LVEF (greater than or equal to 0.50), 105 (51%) met at
least one of the criteria. We conclude that different criteria for CHF will
have varying utility depending on the population being examined, and that a
combination of clinical features and an objective measure of cardiac
performance is needed to diagnose CHF.
ARTICLES
The relationship between left ventricular systolic function and congestive heart failure diagnosed by clinical criteria
Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, NY 10467.
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