Clinical manifestations and diagnosis of asymptomatic left ventricular systolic dysfunction
- Wilson S Colucci, MD
Wilson S Colucci, MD
- Section Editor — Heart Failure
- Professor of Medicine
- Boston University School of Medicine
Asymptomatic left ventricular systolic dysfunction (ALVSD) is defined as depressed LV systolic function in the absence of heart failure (HF). For the discussion in this topic, ALVSD is defined as depressed LV systolic function with a subnormal LV ejection fraction, regional wall motion abnormality, or both. (See 'Definition' below.)
Population-based studies suggest that ALVSD is at least as common as HF with reduced ejection fraction. ALVSD is a risk factor for progression to HF and death. Structural heart disease (including LV systolic dysfunction) without symptoms or signs of HF is defined as "stage B HF" in the American College of Cardiology Foundation/American Heart Association guidelines .
The prevalence, causes, clinical manifestations, and diagnosis of patients with ALVSD will be reviewed here. Management of ALVSD is presented separately. (See "Management and prognosis of asymptomatic left ventricular systolic dysfunction".)
Asymptomatic left ventricular systolic dysfunction (ALVSD) is defined as depressed LV systolic function in the absence of heart failure. Studies of ALVSD have used heterogeneous criteria to identify this condition:
●Patients with depressed LV systolic function may have global dysfunction, regional dysfunction, or both.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Depressed left ventricular ejection fraction
- Wall motion abnormalities
- CLINICAL MANIFESTATIONS
- Symptoms and signs
- Test findings
- - Electrocardiogram
- - Natriuretic peptide levels
- Comparison of BNP and NT-proBNP
- DIAGNOSIS AND EVALUATION
- When to suspect asymptomatic left ventricular systolic dysfunction
- - Approach to identifying high-risk patients
- - No routine screening
- Approach to diagnosis
- Approach to evaluation
- Cardiac imaging for diagnosis and evaluation
- - Echocardiography
- - Other cardiac imaging
- DIFFERENTIAL DIAGNOSIS
- SUMMARY AND RECOMMENDATIONS