Key result
Echocardiography alters management plans for ~41% of elderly patients with HF.
Why the study?
The validity of clinical diagnosis of systolic dysfunction in elderly heart failure patients and the contribution of echocardiography to their management were uncertain.
Does echocardiography improve diagnostic accuracy and influence management in elderly patients with heart failure?
Observational (n=61)
Does echocardiography improve diagnostic accuracy and influence management in elderly patients with heart failure?
Echocardiography significantly improves diagnostic specificity and alters clinical management in elderly patients with heart failure compared to clinical assessment alone.
Echocardiography may refine diagnosis and therapy in elderly heart failure; leaves open whether routine use improves outcomes.
OBJECTIVE: To determine the validity of a clinical diagnosis of systolic dysfunction in elderly patients with heart failure and assess the contribution of echocardiography to their management. SUBJECTS: 61 elderly patients with a diagnosis of heart failure in a geriatric assessment unit setting. METHODS: Prospective study determining sensitivity, specificity and predictive values of a clinical and radiological diagnosis compared with echocardiographic standard. Proposed management was compared before and after echocardiography. RESULTS: Clinical assessment was highly sensitive (93%) but lacked specificity (32%). Combining radiological and clinical diagnoses increased specificity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%. CONCLUSION: For elderly patients with heart failure, echocardiography improves diagnostic accuracy and identifies those patients with potential to benefit from angiotensin-converting enzyme inhibitors.
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A. Hendry (1999) conducted an observational in heart failure (n=61). Echocardiography vs. Clinical and radiological diagnosis was evaluated on Validity of clinical diagnosis of systolic dysfunction and contribution of echocardiography to management. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41% of elderly patients with heart failure.
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