(Circulation. 1998;98:2282-2289.)
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports |
Congestive Heart Failure in the Community
A Study of All Incident Cases in Olmsted County, Minnesota, in 1991
From the Division of Cardiovascular Diseases and Internal Medicine (M.S., C.M.T., R.J.R., M.M.R.), the Department of Health Sciences Research (S.J.J., K.R.B.), and the Division of Community Internal Medicine (J.M.E.), Mayo Clinic and Mayo Foundation, Rochester, Minn.
Background—Data are limited regarding the classification and prognosis of patients with congestive heart failure (CHF) in the community.
Methods and Results—Using the resources of the Rochester
Epidemiology Project, we evaluated all
patients receiving a first diagnosis of CHF in Olmsted County,
Minnesota, in 1991 (n=216). Among these patients, 88% were 
65 years
and 49% were 80 years of age. The prognosis of patients with a new
diagnosis of CHF was poor; survival was 86±2% at 3 months, 76±3% at
1 year, and 35±3% at 5 years. Of the 216 patients, 137 (63%) had an
assessment of ejection fraction. In these patients, systolic
function was preserved (ejection fraction 50%) in 59 (43%) and
reduced (ejection fraction <50%) in 78 (57%). Survival adjusted for
age, sex, NYHA class, and coronary artery disease was not
significantly different between patients with preserved and those with
reduced systolic function (relative risk, 0.80;
P=0.369). ACE inhibitors were used in
only 44% of the total population with CHF.
Conclusions—The present study reports the clinical characteristics and natural history of CHF as it presents in the community in the vasodilator era. CHF is a disease of the "very elderly," frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function. Diagnostic and therapeutic methods are underused in the community.
Key Words: epidemiology • heart failure • prognosis
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N F Murphy, C R Simpson, F A McAlister, S Stewart, K MacIntyre, M Kirkpatrick, J Chalmers, A Redpath, S Capewell, and J J V McMurray National survey of the prevalence, incidence, primary care burden, and treatment of heart failure in Scotland Heart, October 1, 2004; 90(10): 1129 - 1136. [Abstract] [Full Text] [PDF]
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G. P. Aurigemma and W. H. Gaasch Diastolic Heart Failure N. Engl. J. Med., September 9, 2004; 351(11): 1097 - 1105. [Full Text] [PDF]
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M. S. Maurer, M. Packer, D. Burkhoff, D. L. King, M. Grieff, M. R. Zile, C. F. Baicu, W. H. Gaasch, and M. M. Redfield Diastolic Heart Failure N. Engl. J. Med., September 9, 2004; 351(11): 1143 - 1145. [Full Text] [PDF]
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T. E. Sirak, S. Jelic, and T. H. Le Jemtel Therapeutic update: Non-selective beta- and alpha-adrenergic blockade in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure J. Am. Coll. Cardiol., August 4, 2004; 44(3): 497 - 502. [Abstract] [Full Text] [PDF]
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V. L. Roger, S. A. Weston, M. M. Redfield, J. P. Hellermann-Homan, J. Killian, B. P. Yawn, and S. J. Jacobsen Trends in Heart Failure Incidence and Survival in a Community-Based Population JAMA, July 21, 2004; 292(3): 344 - 350. [Abstract] [Full Text] [PDF]
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P. Banerjee, A. L. Clark, N. Nikitin, and J. G.F. Cleland Diastolic heart failure. Paroxysmal or chronic? Eur J Heart Fail, June 1, 2004; 6(4): 427 - 431. [Abstract] [Full Text] [PDF]
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F. Pedersen, I. Raymond, L. H. Madsen, J. Mehlsen, D. Atar, and P. Hildebrandt Echocardiographic indices of left ventricular diastolic dysfunction in 647 individuals with preserved left ventricular systolic function Eur J Heart Fail, June 1, 2004; 6(4): 439 - 447. [Abstract] [Full Text] [PDF]
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A. Bergstrom, B. Andersson, M. Edner, E. Nylander, H. Persson, and U. Dahlstrom Effect of carvedilol on diastolic function in patients with diastolic heart failure and preserved systolic function. Results of the Swedish Doppler-echocardiographic study (SWEDIC) Eur J Heart Fail, June 1, 2004; 6(4): 453 - 461. [Abstract] [Full Text] [PDF]
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T. Mueller, A. Gegenhuber, W. Poelz, and M. Haltmayer Preliminary Evaluation of the AxSYM B-Type Natriuretic Peptide (BNP) Assay and Comparison with the ADVIA Centaur BNP Assay Clin. Chem., June 1, 2004; 50(6): 1104 - 1106. [Full Text] [PDF]
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M C Petrie, K Hogg, L Caruana, and J J V McMurray Poor concordance of commonly used echocardiographic measures of left ventricular diastolic function in patients with suspected heart failure but preserved systolic function: is there a reliable echocardiographic measure of diastolic dysfunction? Heart, May 1, 2004; 90(5): 511 - 517. [Abstract] [Full Text] [PDF]
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M. Klapholz, M. Maurer, A. M. Lowe, F. Messineo, J. S. Meisner, J. Mitchell, J. Kalman, R. A. Phillips, R. Steingart, E. J. Brown Jr, et al. Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction: Results of the New York heart failure registry J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1432 - 1438. [Abstract] [Full Text] [PDF]
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D. Johnson and B. Cujec Reply J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1333 - 1334. [Full Text] [PDF]
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J. Yoshida, K. Yamamoto, T. Mano, Y. Sakata, N. Nishikawa, M. Nishio, T. Ohtani, T. Miwa, M. Hori, and T. Masuyama AT1 Receptor Blocker Added to ACE Inhibitor Provides Benefits at Advanced Stage of Hypertensive Diastolic Heart Failure Hypertension, March 1, 2004; 43(3): 686 - 691. [Abstract] [Full Text] [PDF]
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D. Logeart, G. Thabut, P. Jourdain, C. Chavelas, P. Beyne, F. Beauvais, E. Bouvier, and A. C. Solal Predischarge B-type natriuretic peptide assay for identifying patients at high risk of re-admission after decompensated heart failure J. Am. Coll. Cardiol., February 18, 2004; 43(4): 635 - 641. [Abstract] [Full Text] [PDF]
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K. Hogg, K. Swedberg, and J. McMurray Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosis J. Am. Coll. Cardiol., February 4, 2004; 43(3): 317 - 327. [Abstract] [Full Text] [PDF]
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H. Yamaguchi, J. Yoshida, K. Yamamoto, Y. Sakata, T. Mano, N. Akehi, M. Hori, Y.-J. Lim, M. Mishima, and T. Masuyama Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy J. Am. Coll. Cardiol., January 7, 2004; 43(1): 55 - 60. [Abstract] [Full Text] [PDF]
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C. W. Knudsen, J. S. Riis, A. V. Finsen, L. Eikvar, C. Muller, A. Westheim, and T. Omland Diagnostic value of a rapid test for B-type natriuretic peptide in patients presenting with acute dyspnoe: effect of age and gender Eur J Heart Fail, January 1, 2004; 6(1): 55 - 62. [Abstract] [Full Text] [PDF]
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J. E. Moller, B. Brendorp, M. Ottesen, L. Kober, K. Egstrup, S. H. Poulsen, and C. Torp-Pedersen Congestive heart failure with preserved left ventricular systolic function after acute myocardial infarction: clinical and prognostic implications Eur J Heart Fail, December 1, 2003; 5(6): 811 - 819. [Abstract] [Full Text] [PDF]
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D. S. Lee, P. C. Austin, J. L. Rouleau, P. P. Liu, D. Naimark, and J. V. Tu Predicting Mortality Among Patients Hospitalized for Heart Failure: Derivation and Validation of a Clinical Model JAMA, November 19, 2003; 290(19): 2581 - 2587. [Abstract] [Full Text] [PDF]
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O Wendelboe Nielsen, J Hilden, T McDonagh, and J Fischer Hansen Survival differences between heart failure in general practices and in hospitals Heart, November 1, 2003; 89(11): 1298 - 1302. [Abstract] [Full Text] [PDF]
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