We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Evaluation of different strategies for identifying asymptomatic left ventricular dysfunction and pre-clinical (stage B) heart failure in the elderly. Results from 'PREDICTOR', a population based-study in central Italy.
- Authors
Mureddu, Gian Francesco; Tarantini, Luigi; Agabiti, Nera; Faggiano, Pompilio; Masson, Serge; Latini, Roberto; Cesaroni, Giulia; Miceli, Maria; Forastiere, Francesco; Scardovi, Angela Beatrice; Uguccioni, Massimo; Boccanelli, Alessandro
- Abstract
<bold>Aims: </bold>To evaluate the accuracy and cost-effectiveness of different screening strategies to identify systolic and/or diastolic asymptomatic LV dysfunction (ALVD), as well as pre-clinical (stage B) heart failure (HF), in a community of elderly subjects in Italy. <bold>Methods and Results: </bold>A sample of 1452 subjects aged 65-84 years were chosen from the original cohort of 2001 randomly selected residents of the Lazio Region (Italy), as a part of the PREDICTOR survey. All subjects underwent physical examination, biochemistry/NT-proBNP assessment, 12-lead ECG, and Doppler transthoracic echocardiography (TE). Five strategies were evaluated including ECG, NT-proBNP, TE, and their combinations. Subjects older than 75 years, and with at least two additional risk factors, were defined as being high-risk for HF (435), whereas the remaining 1017 were defined at low risk. Screening characteristics and cost-effectiveness (cost per case) of the five strategies to predict systolic (EF <50% ) or diastolic ALVD and pre-clinical HF (stage B) were compared. NT-proBNP was the most accurate and cost-effective screening strategy to identify systolic and moderate to severe diastolic LV dysfunction without a difference between the high-risk and low-risk groups. Adding ECG to the NT-proBNP assessment did not improve the detection of pre-clinical LV dysfunction. TE-based screening was the least cost-effective strategy. In fact, all screening strategies were inadequate to identify stage B HF. <bold>Conclusions: </bold>In a community of elderly people, NT-proBNP is the most accurate and cost- effective pre-screening strategy to identify systolic and moderate to severe diastolic LV dysfunction.
- Publication
European Journal of Heart Failure, 2013, Vol 15, Issue 10, p1102
- ISSN
1388-9842
- Publication type
journal article
- DOI
10.1093/eurjhf/hft098