Medline ® Abstracts for References 5,6
of 'Epidemiology and causes of heart failure'
Classification of heart failure in population based research: an assessment of six heart failure scores.
Mosterd A, Deckers JW, Hoes AW, Nederpel A, Smeets A, Linker DT, Grobbee DE
Eur J Epidemiol. 1997;13(5):491.
Several scores based on symptoms and signs have been developed to assess the presence of heart failure. The goal of this study was to compare six heart failure scores in non-hospitalised subjects and to determine their usefulness in population based research. The scores were applied to 54 participants of a population based study. All underwent a complete medical examination, including chest X-ray, electrocardiography and Doppler echocardiography. Using all information available, a cardiologist, unaware of the results of the scores, clinically classified participants as having no, possible or definite heart failure. Sensitivity, specificity, predictive values and receiver operating characteristics were calculated, using the cardiologist's assessment as a gold standard. The cardiologist judged definite or possible heart failure to be present in 17 persons. All scores had a high sensitivity for the detection of definite heart failure, whereas the study of men born in 1913 and Walma's score had the highest sensitivity for the combination of possible and definite heart failure. Gheorgiade's and the Boston score had the highest positive predictive values. In conclusion, five of the six scores we studied are broadly similar in the detection of heart failure. The men born in 1913 score relies heavily on the assessment of dyspnea, resulting in a relatively large number of false positives. Although the scores are useful in detecting manifest heart failure, objective measurements of cardiac function appear necessary to reduce the false positive rate and accurately detect early stages of heart failure.
Department of Epidemiology and Biostatistics, University Hospital Rotterdam Dijkzigi, The Netherlands.
The heart failure epidemic.
Int J Environ Res Public Health. 2010 Apr;7(4):1807-30. Epub 2010 Apr 19.
Heart failure has been singled out as an emerging epidemic, which could be the result of increased incidence and/or increased survival leading to increased prevalence. Knowledge of the responsibility of each factor in the genesis of the epidemic is crucial for prevention. Population-based studies have shown that, over time, the incidence of heart failure remained overall stable, while survival improved. Therefore, the heart failure epidemic is chiefly one of hospitalizations. Data on temporal trends in the incidence and prevalence of heart failure according to ejection fraction and how it may have changed over time are needed while interventions should focus on reducing the burden of hospitalizations in hear failure.
Division of Cardiovascular Diseases, Department of Internal Medicine and the Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA. email@example.com