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(Circulation. 2003;108:e9014.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Asymptomatic Left Ventricular Systolic Dysfunction—A Pending Disaster

Even mild, asymptomatic left ventricular systolic dysfunction increases the risk of congestive heart failure and death, said researchers from the famous Framingham Heart Study in a report in this week’s issue of the journal Circulation (Circulation. 2003;108:977–982)[Abstract/Free Full Text].

Researchers led by Thomas J. Wang, MD, of the Massachusetts General Hospital, Boston, Mass, studied 4257 participants in the Framingham Study who had undergone routine echocardiography. Of these, 6% of the men and 0.8% of the women had asymptomatic left ventricular systolic dysfunction. During the 12 years of follow-up, subjects with normal left ventricular function greater than 50% developed congestive heart failure at a rate of 0.7 per 100 person-years. Those with asymptomatic left ventricular systolic dysfunction developed the disorder at a rate of 5.8 per 100 person-years. With adjustment for cardiovascular disease risk factors, the hazard ratio for congestive heart failure among patients with left ventricular dysfunction was 4.7 compared to those with normal heart function.

Asymptomatic left ventricular systolic dysfunction was also associated with an increased risk of death. Median survival among those with the dysfunction was 7.1 years. The researchers concluded: "Individuals with ALVD [asymptomatic left ventricular systolic dysfunction] in the community are at high risk of CHF [congestive heart failure] and death, even when only mild impairment of EF [ejection fraction] is present. Additional studies are needed to define optimal therapy for mild ALVD."

Mismatch in Aortic Valve Replacement Can Increase Short-Term Mortality
When the prosthesis used in aortic valve replacement is too small for the patient’s body size, it increases the risk of death . . . [Full Text of this Article]