What is a sign of worsening heart failure in older adults

1. Ahmed A. Clinical manifestations, diagnostic assessment, and etiology of heart failure in older adults. Clin Geriatr Med. 2007;23:11–30. [PubMed] [Google Scholar]

2. Ahmed A, Allman RM, Aronow WS, DeLong JF. Diagnosis of heart failure in older adults: predictive value of dyspnea at rest. Arch Gerontol Geriatr. 2004;38:297–307. [PubMed] [Google Scholar]

3. Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154–235. [PubMed] [Google Scholar]

4. Adams K, Lindenfeld J, Arnold J, et al. Executive Summary: HFSA 2006 Comprehensive Heart Failure Practice Guideline. J Cardiac Failure. 2006;12:10–38. [PubMed] [Google Scholar]

5. Ahn SA, Jong P, Yusuf S, Bangdiwala SI, Pouleur HG, Rousseau MF. Early enalapril therapy reduced cardiovascular morbidity and mortality in patients with left ventricular systolic dysfunction: Results at 15 years in SOLVD. Abstract presented at the Scientific Sessions 2004 in New Orleans, LA. Circulation. 2004;110:III-367. [Google Scholar]

6. Braunwald E, Colluci WS, Grossman W. Clinical aspects of heart failure: High-ouput heart failure; pulmonary edema. In: Braunwald E, editor. Heart Disease: A text book of cardiovascular medicine. 5. Vol. 1. Philadelphia: W. B. Saunders Company; 1997. pp. 445–470. [Google Scholar]

7. Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005;294:1944–1956. [PubMed] [Google Scholar]

8. Perloff JK, Braunwald E. Physical examination of the heart fand circulation. In: Braunwald E, editor. Heart Disease: A text book of cardiovascular medicine. 5. Vol. 1. Philadelphia: W. B. Saunders Company; 1997. pp. 15–52. [Google Scholar]

9. Ahmed A, Allman RM, Kiefe CI, et al. Association of consultation between generalists and cardiologists with quality and outcomes of heart failure care. Am Heart J. 2003;145:1086–1093. [PubMed] [Google Scholar]

10. Mueller C, Scholer A, Laule-Kilian K, et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004;350:647–654. [PubMed] [Google Scholar]

11. Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E. Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. J Am Coll Cardiol. 1993;22:968–974. [PubMed] [Google Scholar]

12. Curtis JP, Selter JG, Wang Y, et al. The obesity paradox: body mass index and outcomes in patients with heart failure. Arch Intern Med. 2005;165:55–61. [PubMed] [Google Scholar]

13. Drazner MH, Rame JE, Stevenson LW, Dries DL. Prognostic importance of elevated jugular venous pressure and a third heart sound in patients with heart failure. N Engl J Med. 2001;345:574–581. [PubMed] [Google Scholar]

14. Fonarow GC, Stough WG, Abraham WT, et al. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure: a report from the OPTIMIZE-HF Registry. J Am Coll Cardiol. 2007;50:768–777. [PubMed] [Google Scholar]

15. Vinayak AG, Levitt J, Gehlbach B, Pohlman AS, Hall JB, Kress JP. Usefulness of the external jugular vein examination in detecting abnormal central venous pressure in critically ill patients. Arch Intern Med. 2006;166:2132–2137. [PubMed] [Google Scholar]

16. Ducas J, Magder S, McGregor M. Validity of the hepatojugular reflux as a clinical test for congestive heart failure. Am J Cardiol. 1983;52:1299–1303. [PubMed] [Google Scholar]

17. Sochowski RA, Dubbin JD, Naqvi SZ. Clinical and hemodynamic assessment of the hepatojugular reflux. Am J Cardiol. 1990;66:1002–1006. [PubMed] [Google Scholar]

18. Seth R, Magner P, Matzinger F, van Walraven C. How far is the sternal angle from the mid-right atrium? J Gen Intern Med. 2002;17:852–856. [PMC free article] [PubMed] [Google Scholar]

19. Donaldson MC. Chronic Venous Insufficiency. Curr Treat Options Cardiovasc Med. 2000;2:265–272. [PubMed] [Google Scholar]

20. Kannel WB. Vital epidemiologic clues in heart failure. J Clin Epidemiol. 2000;53:229–235. [PubMed] [Google Scholar]

21. Gottdiener JS, Arnold AM, Aurigemma GP, et al. Predictors of congestive heart failure in the elderly: the Cardiovascular Health Study. J Am Coll Cardiol. 2000;35:1628–1637. [PubMed] [Google Scholar]

22. Centers for Medicare & Medicaid Services. Overview of specifications of measures displayed on hospital compare as of December 15, 2005. [Access date: June 3, 2006]. 2006. //www.cms.hhs.gov/HospitalQualityInits/10_HospitalQualityMeasures.asp#TopOfPage.

23. Joint Commission on Accreditation of Healthcare Organizations. A comprehensive review of development and testing for national implementation of hospital core measures. [Access date: June 3, 2006]. 2006. //www.jointcommission.org/NR/exeres/5A8BFA1C-B844-4A9A-86B2-F16DBE0E20C7.htm.

24. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med. 1991;325:293–302. [PubMed] [Google Scholar]

25. Pfeffer MA, Braunwald E, Moye LA, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. N Engl J Med. 1992;327:669–677. [PubMed] [Google Scholar]

26. The Digitalis Investigation Group. The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 1997;336:525–533. [PubMed] [Google Scholar]

27. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. New England Journal of Medicine. 1996;334:1349–1355. [PubMed] [Google Scholar]

28. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) Lancet. 1999;353:2001–2007. [PubMed] [Google Scholar]

29. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999;341:709–717. [PubMed] [Google Scholar]

30. Pitt B, Poole-Wilson PA, Segal R, et al. Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial--the Losartan Heart Failure Survival Study ELITE II. Lancet. 2000;355:1582–1587. [PubMed] [Google Scholar]

31. Hogg K, Swedberg K, McMurray J. Heart failure with preserved left ventricular systolic function; epidemiology, clinical characteristics, and prognosis. J Am Coll Cardiol. 2004;43:317–327. [PubMed] [Google Scholar]

32. Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort. J Am Coll Cardiol. 1999;33:1948–1955. [PubMed] [Google Scholar]

33. Gottdiener JS, McClelland RL, Marshall R, et al. Outcome of congestive heart failure in elderly persons: influence of left ventricular systolic function. The Cardiovascular Health Study. Ann Intern Med. 2002;137:631–639. [PubMed] [Google Scholar]

34. Senni M, Redfield MM. Heart failure with preserved systolic function. A different natural history? J Am Coll Cardiol. 2001;38:1277–1282. [PubMed] [Google Scholar]

35. Redfield MM, Jacobsen SJ, Burnett JC, Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA. 2003;289:194–202. [PubMed] [Google Scholar]

36. Zile MR, Gaasch WH, Carroll JD, et al. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure? Circulation. 2001;104:779–782. [PubMed] [Google Scholar]

37. Kitzman DW, Little WC, Brubaker PH, et al. Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA. 2002;288:2144–2150. [PubMed] [Google Scholar]

38. Ahmed A, Roseman JM, Duxbury AS, Allman RM, DeLong JF. Correlates and outcomes of preserved left ventricular systolic function among older adults hospitalized with heart failure. Am Heart J. 2002;144:365–372. [PubMed] [Google Scholar]

39. Ahmed A, Nanda NC, Weaver MT, Allman RM, DeLong JF. Clinical correlates of isolated left ventricular diastolic dysfunction among hospitalized older heart failure patients. Am J Geriatr Cardiol. 2003;12:82–89. [PubMed] [Google Scholar]

40. Ahmed A. Association of diastolic dysfunction and outcomes in ambulatory older adults with chronic heart failure. J Gerontol A Biol Sci Med Sci. 2005;60:1339–1344. [PMC free article] [PubMed] [Google Scholar]

41. Radford MJ, Arnold JM, Bennett SJ, et al. ACC/AHA key data elements and definitions for measuring the clinical management and outcomes of patients with chronic heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Heart Failure Clinical Data Standards): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Failure Society of America. Circulation. 2005;112:1888–1916. [PubMed] [Google Scholar]

42. Cheitlin MD, Armstrong WF, Aurigemma GP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography) Circulation. 2003;108:1146–1162. [PubMed] [Google Scholar]

43. Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure--abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350:1953–1959. [PubMed] [Google Scholar]

44. Thomas JD, Choong CY, Flachskampf FA, Weyman AE. Analysis of the early transmitral Doppler velocity curve: effect of primary physiologic changes and compensatory preload adjustment. J Am Coll Cardiol. 1990;16:644–655. [PubMed] [Google Scholar]

45. Swedberg K, Cleland J, Dargie H, et al. Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005): The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26:1115–1140. [PubMed] [Google Scholar]

46. Fleg JL, Shapiro EP, O’Connor F, Taube J, Goldberg AP, Lakatta EG. Left ventricular diastolic filling performance in older male athletes. JAMA. 1995;273:1371–1375. [PubMed] [Google Scholar]

47. Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30:1527–1533. [PubMed] [Google Scholar]

48. Sohn DW, Chai IH, Lee DJ, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol. 1997;30:474–480. [PubMed] [Google Scholar]

49. Cosentino AM. The congested state in renal failure: A historical and diagnostic perspective. Seminars In Dialysis. 1999;12:307–310. [Google Scholar]

50. Warren JV, Stead EA., Jr Fluid dynamics in chronic congestive heart failure. Arch Intern Med. 1944;73:138–147. [Google Scholar]

51. Merrill AJ. Edema and decreased renal blood flow in patients with chronic congestive heart failure: Evidence of "forward failure" as the primary cause of edema. J Clin Invest. 1946;25:389–400. [PMC free article] [PubMed] [Google Scholar]

52. Ingram CW, Satler LF, Rackley CE. Progressive heart failure secondary to a high output state. Chest. 1987;92:1117–1118. [PubMed] [Google Scholar]

53. Froeschl M, Haddad H, Commons AS, Veinot JP. Thyrotoxicosis-an uncommon cause of heart failure. Cardiovasc Pathol. 2005;14:24–27. [PubMed] [Google Scholar]

54. Ahearn DJ, Maher JF. Heart failure as a complication of hemodialysis arteriovenous fistula. Ann Intern Med. 1972;77:201–204. [PubMed] [Google Scholar]

55. Nieminen MS, Bohm M, Cowie MR, et al. Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J. 2005;26:384–416. [PubMed] [Google Scholar]

56. Kramer K, Kirkman P, Kitzman D, Little WC. Flash pulmonary edema: association with hypertension and reoccurrence despite coronary revascularization. Am Heart J. 2000;140:451–455. [PubMed] [Google Scholar]

57. Gheorghiade M, Zannad F, Sopko G, et al. Acute heart failure syndromes: current state and framework for future research. Circulation. 2005;112:3958–3968. [PubMed] [Google Scholar]

58. Ahmed A, Kiefe CI, Allman RM, Sims RV, DeLong JF. Survival benefits of angiotensin-converting enzyme inhibitors in older heart failure patients with perceived contraindications. J Am Geriatr Soc. 2002;50:1659–1666. [PubMed] [Google Scholar]

59. Ahmed A. Use of angiotensin-converting enzyme inhibitors in patients with heart failure and renal insufficiency: how concerned should we be by the rise in serum creatinine? J Am Geriatr Soc. 2002;50:1297–1300. [PubMed] [Google Scholar]

60. Ahmed A, Dell'Italia LJ. Use of beta-blockers in older adults with chronic heart failure. Am J Med Sci. 2004;328:100–111. [PubMed] [Google Scholar]

61. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309–1321. [PubMed] [Google Scholar]

62. Ahmed A, Rich MW, Love TE, et al. Digoxin and reduction in mortality and hospitalization in heart failure: a comprehensive post hoc analysis of the DIG trial. Eur Heart J. 2006;27:178–186. [PMC free article] [PubMed] [Google Scholar]

63. Ahmed A, Young JB, Gheorghiade M. The underuse of digoxin in heart failure, and approaches to appropriate use. CMAJ. 2007;176:641–643. [PMC free article] [PubMed] [Google Scholar]

64. Ahmed A, Pitt B, Rahimtoola SH, et al. Effects of digoxin at low serum concentrations on mortality and hospitalization in heart failure: a propensity-matched study of the DIG trial. Int J Cardiol. 2008;123:138–146. [PMC free article] [PubMed] [Google Scholar]

65. Ahmed A, Husain A, Love TE, et al. Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity score methods. Eur Heart J. 2006;27:1431–1439. [PMC free article] [PubMed] [Google Scholar]

66. Ahmed A, Young JB, Love TE, Levesque R, Pitt B. A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure. Int J Cardiol. 2008;125:246–253. [PMC free article] [PubMed] [Google Scholar]

67. Ahmed A, Zannad F, Love TE, et al. A propensity-matched study of the association of low serum potassium levels and mortality in chronic heart failure. Eur Heart J. 2007;28:1334–1343. [PMC free article] [PubMed] [Google Scholar]

68. Ahmed A, Rich MW, Fleg JL, et al. Effects of digoxin on morbidity and mortality in diastolic heart failure: the ancillary digitalis investigation group trial. Circulation. 2006;114:397–403. [PMC free article] [PubMed] [Google Scholar]

69. Yusuf S, Pfeffer MA, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777–781. [PubMed] [Google Scholar]

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Despite differences in systolic and diastolic function between systolic and diastolic heart failure, both have low cardiac output, the hallmark of heart failure and very similar clinical presentation. All data based on left ventricle. (Adapted from Ahmed A. Clinical manifestations, diagnostic assessment, and etiology of heart failure in older adults. Clin Geriatr Med. 2007;23:11–30)

LV EDV (ml)LV EF (%)LV SV (ml)HR (bpm)LV CO (l/min)Symptoms
Normal14055%80655.2None
Systolic heart failure20025%50753.8Dyspnea, fatigue, edema
Diastolic heart failure8060%50753.8Dyspnea, fatigue, edema

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