Department of Cardiovascular Diseases, S. Giovanni-Addolorata Hospital, 00184 Rome, Italy.
Eur J Heart Fail. 2012 Jul;14(7):718-29. doi: 10.1093/eurjhf/hfs052. Epub 2012 May 4.
We conducted a population-based cross-sectional study to assess the prevalence of both preclinical and clinical heart failure (HF) in the elderly.
A sample of 2001 subjects, 65- to 84-year-old residents in the Lazio Region (Italy), underwent physical examination, biochemistry/N-terminal pro brain natriuretic peptide (NT-proBNP) assessment, electrocardiography, and echocardiography. Systolic left ventricular dysfunction (LVD) was defined as left ventricular ejection fraction (LVEF) <50%. Diastolic LVD was defined by a Doppler-derived multiparametric algorithm. The overall prevalence of HF was 6.7% [95% confidence interval (CI) 5.6-7.9], mainly due to HF with preserved LVEF (HFpEF) (4.9%; 95% CI 4.0-5.9), and did not differ by gender. A systolic asymptomatic LVD (ALVD) was detected more frequently in men (1.8%; 95% CI 1.0-2.7) than in women (0.5%; 95% CI 0.1-1.0; P = 0.005), whereas the prevalence of diastolic ALVD was comparable between genders (men: 35.8%; 95% CI = 32.7-38.9; women: 35.0%; 95% CI = 31.9-38.2). The NT-proBNP levels and severity of LVD increased with age. Overall, 1623 subjects (81.1% of the entire studied population) had preclinical HF (Stage A: 22.2% and stage B: 59.1% respectively). A large number of subjects in stage B of HF showed risk factor levels not at target.
In a population-based study, the prevalence of preclinical HF in the elderly is high. The prevalence of clinical HF is mainly due to HFpEF and is similar between genders.
我们进行了一项基于人群的横断面研究，以评估老年人中临床前和临床心力衰竭（HF）的患病率。
在意大利拉齐奥地区，对 2001 名年龄在 65 至 84 岁的居民进行了体格检查、生物化学/氨基末端脑利钠肽前体（NT-proBNP）评估、心电图和超声心动图检查。收缩性左心室功能障碍（LVD）定义为左心室射血分数（LVEF）<50%。舒张性 LVD 通过多普勒衍生的多参数算法定义。HF 的总体患病率为 6.7%[95%置信区间（CI）5.6-7.9]，主要归因于射血分数保留的 HF（HFpEF）（4.9%；95%CI 4.0-5.9），且不受性别影响。男性中更常发现无症状性收缩性 LVD（ALVD）（1.8%；95%CI 1.0-2.7），而女性中（0.5%；95%CI 0.1-1.0；P=0.005）则较少见，两性间舒张性 ALVD 的患病率相当（男性：35.8%；95%CI=32.7-38.9；女性：35.0%；95%CI=31.9-38.2）。NT-proBNP 水平和 LVD 严重程度随年龄增长而增加。总体而言，1623 名受试者（整个研究人群的 81.1%）患有临床前 HF（A 期：22.2%，B 期：59.1%）。HF B 期的大量患者存在未达标的危险因素水平。
在一项基于人群的研究中，老年人中临床前 HF 的患病率较高。临床 HF 的患病率主要归因于 HFpEF，且在两性间相似。
