Abstract 3108: Clinical Characteristics of Left Ventricular Systolic Dysfunction without Heart Failure in Community-Based Elderly Individuals: The Cardiovascular Health Study
Left ventricular systolic dysfunction without heart failure (HF), also known as asymptomatic left ventricular systolic dysfunction (ALVSD), is at least as prevalent in the general population as left ventricular systolic dysfunction with heart failure (HF-LVSD). However, the clinical characteristics of ALVSD have not been well defined in an elderly population. Our aim is to evaluate the clinical features of elderly community-based individuals with ALVSD. The Cardiovascular Health Study is a multicenter cohort study designed to assess cardiovascular risk factors and outcomes in a population 65 years and older. This study quantifies baseline demographic variables and cardiovascular risk factors in participants with ALVSD. Comparisons were made with two reference groups: individuals with HF-LVSD, and those with normal left ventricular systolic function without HF (NL-LVSF). ALVSD was present in 385 of 5152 participants (7.5%) at baseline, whereas HF-LVSD was present in 84 participants (1.6%). Among those with ALVSD, 251 (65.2%) had borderline ejection fraction (EF) (45–54%), and 134 (34.8%) had impaired EF (< 45%). ALVSD was associated with elevated cardiovascular risk factors and comorbidities compared to NL-LVSF but lower than those in individuals with HF-LVSD (see table⇓). Among participants with ALVSD, impaired EF was associated with male sex and higher prevalence of coronary disease and LVH compared with borderline LV function. ALVSD is more common than HF-LVSD in community-dwelling elderly individuals. Furthermore, it is characterized by more cardiac risk factors and comorbidities than those with NL-LVSF, but less than those with HF-LVSD. The severity of systolic dysfunction is associated with comorbid cardiovascular risk factors. ALVSD may identify an important group of individuals at high risk for heart failure and cardiovascular mortality.