The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: a case-control study

Robert Kelly, Anthony Staines, Ron MacWalter, Peter Stonebridge, Hugh Tunstall-Pedoe, Allan D. Struthers

    Research output: Contribution to journalArticle

    31 Citations (Scopus)

    Abstract

    Objectives: We sought to determine the prevalence of treatable left ventricular (LV) systolic dysfunction (LVSD) in patients who present with their first noncardiac vascular episode. Background: Screening for LV dysfunction in patients who present with their first stroke (cerebrovascular accident), their first transient ischemic attack (TIA) or their first manifestation of peripheral vascular disease (PVD) may represent a golden opportunity to identify treatable LV dysfunction, and so their known high incidence of sudden cardiac death may be reduced. Methods: Participating in this study were 522 (75%) of 700 consecutive patients (302 patients with stroke, TIA or PVD and 220 age- and gender-matched control subjects). Each underwent a full clinical assessment, 12-lead electrocardiography and two-dimensional echocardiography. Left ventricular dysfunction was defined as LV ejection fraction =40%. Results: Seventy-two (28%) patients with vascular disease and 11 (5.5%) control subjects were found to have LVSD. Twenty-six (28%) stroke patients, 22 (26%) patients with TIA and 24 (31%) patients with PVD had LVSD. Left ventricular systolic dysfunction was symptomatic in 44% of patients and in 35% of control subjects. Conclusions: Left ventricular systolic dysfunction is five times more common among patients with stroke, TIA and PVD than among age- and gender-matched control subjects. Asymptomatic LVSD is more common than symptomatic LVSD in these patients. These findings suggest that routine screening of all patients with noncardiac vascular episodes for LVSD should now be considered. Future studies should investigate whether identifying and treating LVSD in these patients would reduce their known high rate of cardiac death.
    Original languageEnglish
    Pages (from-to)219-224
    Number of pages6
    JournalJournal of the American College of Cardiology
    Volume39
    Issue number2
    DOIs
    Publication statusPublished - Jan 2002

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    Left Ventricular Dysfunction
    Blood Vessels
    Case-Control Studies
    Peripheral Vascular Diseases
    Transient Ischemic Attack
    Stroke
    Sudden Cardiac Death
    Vascular Diseases
    Stroke Volume
    Echocardiography
    Electrocardiography

    Keywords

    • Left ventricular systolic dysfunction (LVSD)
    • LVSD
    • Noncardiac vascular episodes

    Cite this

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    title = "The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: a case-control study",
    abstract = "Objectives: We sought to determine the prevalence of treatable left ventricular (LV) systolic dysfunction (LVSD) in patients who present with their first noncardiac vascular episode. Background: Screening for LV dysfunction in patients who present with their first stroke (cerebrovascular accident), their first transient ischemic attack (TIA) or their first manifestation of peripheral vascular disease (PVD) may represent a golden opportunity to identify treatable LV dysfunction, and so their known high incidence of sudden cardiac death may be reduced. Methods: Participating in this study were 522 (75{\%}) of 700 consecutive patients (302 patients with stroke, TIA or PVD and 220 age- and gender-matched control subjects). Each underwent a full clinical assessment, 12-lead electrocardiography and two-dimensional echocardiography. Left ventricular dysfunction was defined as LV ejection fraction =40{\%}. Results: Seventy-two (28{\%}) patients with vascular disease and 11 (5.5{\%}) control subjects were found to have LVSD. Twenty-six (28{\%}) stroke patients, 22 (26{\%}) patients with TIA and 24 (31{\%}) patients with PVD had LVSD. Left ventricular systolic dysfunction was symptomatic in 44{\%} of patients and in 35{\%} of control subjects. Conclusions: Left ventricular systolic dysfunction is five times more common among patients with stroke, TIA and PVD than among age- and gender-matched control subjects. Asymptomatic LVSD is more common than symptomatic LVSD in these patients. These findings suggest that routine screening of all patients with noncardiac vascular episodes for LVSD should now be considered. Future studies should investigate whether identifying and treating LVSD in these patients would reduce their known high rate of cardiac death.",
    keywords = "Left ventricular systolic dysfunction (LVSD), LVSD, Noncardiac vascular episodes",
    author = "Robert Kelly and Anthony Staines and Ron MacWalter and Peter Stonebridge and Hugh Tunstall-Pedoe and Struthers, {Allan D.}",
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    The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: a case-control study. / Kelly, Robert; Staines, Anthony; MacWalter, Ron; Stonebridge, Peter; Tunstall-Pedoe, Hugh; Struthers, Allan D.

    In: Journal of the American College of Cardiology, Vol. 39, No. 2, 01.2002, p. 219-224.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: a case-control study

    AU - Kelly, Robert

    AU - Staines, Anthony

    AU - MacWalter, Ron

    AU - Stonebridge, Peter

    AU - Tunstall-Pedoe, Hugh

    AU - Struthers, Allan D.

    N1 - dc.publisher: Elsevier

    PY - 2002/1

    Y1 - 2002/1

    N2 - Objectives: We sought to determine the prevalence of treatable left ventricular (LV) systolic dysfunction (LVSD) in patients who present with their first noncardiac vascular episode. Background: Screening for LV dysfunction in patients who present with their first stroke (cerebrovascular accident), their first transient ischemic attack (TIA) or their first manifestation of peripheral vascular disease (PVD) may represent a golden opportunity to identify treatable LV dysfunction, and so their known high incidence of sudden cardiac death may be reduced. Methods: Participating in this study were 522 (75%) of 700 consecutive patients (302 patients with stroke, TIA or PVD and 220 age- and gender-matched control subjects). Each underwent a full clinical assessment, 12-lead electrocardiography and two-dimensional echocardiography. Left ventricular dysfunction was defined as LV ejection fraction =40%. Results: Seventy-two (28%) patients with vascular disease and 11 (5.5%) control subjects were found to have LVSD. Twenty-six (28%) stroke patients, 22 (26%) patients with TIA and 24 (31%) patients with PVD had LVSD. Left ventricular systolic dysfunction was symptomatic in 44% of patients and in 35% of control subjects. Conclusions: Left ventricular systolic dysfunction is five times more common among patients with stroke, TIA and PVD than among age- and gender-matched control subjects. Asymptomatic LVSD is more common than symptomatic LVSD in these patients. These findings suggest that routine screening of all patients with noncardiac vascular episodes for LVSD should now be considered. Future studies should investigate whether identifying and treating LVSD in these patients would reduce their known high rate of cardiac death.

    AB - Objectives: We sought to determine the prevalence of treatable left ventricular (LV) systolic dysfunction (LVSD) in patients who present with their first noncardiac vascular episode. Background: Screening for LV dysfunction in patients who present with their first stroke (cerebrovascular accident), their first transient ischemic attack (TIA) or their first manifestation of peripheral vascular disease (PVD) may represent a golden opportunity to identify treatable LV dysfunction, and so their known high incidence of sudden cardiac death may be reduced. Methods: Participating in this study were 522 (75%) of 700 consecutive patients (302 patients with stroke, TIA or PVD and 220 age- and gender-matched control subjects). Each underwent a full clinical assessment, 12-lead electrocardiography and two-dimensional echocardiography. Left ventricular dysfunction was defined as LV ejection fraction =40%. Results: Seventy-two (28%) patients with vascular disease and 11 (5.5%) control subjects were found to have LVSD. Twenty-six (28%) stroke patients, 22 (26%) patients with TIA and 24 (31%) patients with PVD had LVSD. Left ventricular systolic dysfunction was symptomatic in 44% of patients and in 35% of control subjects. Conclusions: Left ventricular systolic dysfunction is five times more common among patients with stroke, TIA and PVD than among age- and gender-matched control subjects. Asymptomatic LVSD is more common than symptomatic LVSD in these patients. These findings suggest that routine screening of all patients with noncardiac vascular episodes for LVSD should now be considered. Future studies should investigate whether identifying and treating LVSD in these patients would reduce their known high rate of cardiac death.

    KW - Left ventricular systolic dysfunction (LVSD)

    KW - LVSD

    KW - Noncardiac vascular episodes

    U2 - 10.1016/S0735-1097(01)01725-9

    DO - 10.1016/S0735-1097(01)01725-9

    M3 - Article

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    SP - 219

    EP - 224

    JO - Journal of the American College of Cardiology

    JF - Journal of the American College of Cardiology

    SN - 0735-1097

    IS - 2

    ER -