Focale: Study of systolic and diastolic heart failure in a French elderly population

Context: The epidemic of heart failure (HF) in France has not been fully investigated and data on both the systolic and diastolic forms are limited. Objectives: To determine the prevalence, aetiology and treatments of both forms in French patients over 65 with HF (NYHA grade II-IV). Participants: Cross-sectional study of 446 patients with HF recruited by 273 randomly selected cardiologists in France, with echocardiography and ECG available for central reading. Main measurements: Prevalence of diastolic (DHF) and systolic (SHF) HF using the left ventricular ejection fraction (LVEF). Results: DHF, with a mean LVEF of 57.6 +/- 8.0%, was reported for 245 (54.9%) patients and SHF, with a mean LVEF of 33.33 +/- 8.0% was reported for 201 (45.1%) patients. Men were more prone to suffer SHF than DHF whereas for women the reverse was true. As compared to SHF, DHF endsystolic and enddiastolic volumes were smaller, the thickness/radius ratio was greater, with a longer E-wave deceleration time and a shorter peak filling rate. Aetiology and treatments were similar in both types of HF, except for ACE inhibitors and aldosterone antagonists, which were more frequently prescribed in SHF. Conclusion: This observational study provides further knowledge of SHF and DHF in outpatients. (c) 2007 Elsevier Ireland Ltd. All rights reserved.