Ranjith, P (2011) A Study on Prevalence and Associated Factors of Diastolic Heart Failure in Elderly with Congestive Heart Failure. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Diastolic Heart failure (DHF) is characterized by signs and /or symptoms of heart failure in presence of a normal ejection fraction (EF).Prognosis of DHF is as poor as that of systolic failure, and the number of cases is likely to increase within aging populations. Heart failure with normal systolic function has been equated to diastolic heart failure (DHF). DHF appears to be quite common in the elderly, especially in elderly women with hypertension. Recent epidemiologic studies suggest that 30%-50% of patients with heart failure may have DHF. Morbidity for DHF is comparable to that of heart failure with left ventricular systolic dysfunction. Both groups of patients have similar rates of recurrent hospitalization and cost of care. Long-term mortality also appears to be similar in the two groups of patients. With the aging of the population, the number of patients with DHF will continue to rise and are likely to contribute significantly to the burden of disease caused by heart failure. Unfortunately, as yet, no reliable definition has been found for DHF. Currently the diagnosis of DHF is often made by exclusion, and treatment is empirical and unsatisfactory because of the lack of large-scale, randomized, controlled trials in this area; however, several large and other smaller trials are currently in progress that will hopefully provide some answers. AIM OF THE STUDY: 1. To assess the the prevalence of diastolic heart failure in elderly with congestive heart failure. 2. To study the association with demographic factors like 1. Age, 2. Sex and comorbid conditions like; 1. Hypertension, 2. Diabetes mellitus, 3. Coronary artery disease, 4. Atrial Fibrillation, 5. Chronic kidney disease, 6. Hypothyroidism, 7. Obesity. MATERIALS AND METHODS: Study Centre: Department of Geriatric medicine, Madras Medical College & Government General Hospital Chennai - 600003. Study Design: Cross sectional, descriptive study. Sample Size: Ninety. Study Duration: August 2008 - September 2011. Selection Of Patients: Inclusion Criteria: 90 elderly patients age ≥ 60 admitted with typical signs and symptoms of congestive heart failure are included in this study. Exclusion Criteria: Patients with evidence of 1. Congenital heart disease, 2. Valvular heart disease, 3. Pericardial disease and 4. High output heart failure (severe anemia, Thyrotoxicosis, AV fistula) are excluded from this study. METHODOLOGY: The study enrolled 90 patients admitted in Govt general hospital with features of congestive heart failure according to Framingham criteria. Age group selected for this study are ≥ 60 yrs, individuals were characterized by detailed medical history, clinical examination, ECG, Chest X-ray, echocardiography, and following lab tests: Hb, blood sugar, urea, serum creatinine, serum electrolytes, serum albumin and LDL. DHF was defined as; 1. Clinical signs of heart failure, 2. Ejection fraction ≥ 50, 3. Echocardiographic findings of diastolic dysfunction. CONCLUSION: • 40 - 50% of elderly with CHF have DHF. • The prevalence of DHF has increased with age and appears to be quite common in elderly women with hypertension. • T he diagnosis of DHF is generally based on typical symptoms and signs of HF, preserved or normal LVEF, DD and no valvular abnormalities. • The goal of therapy is the relief of symptoms, improvement in quality of life (improved exercise tolerance and reduced hospital admissions), and prolongation of survival. In the elderly, relief of symptoms and improvement of quality of life are crucial. • The outcomes of pharmacological therapy in patients with DHF are frequently neutral in clinical trials. Further trials are necessary to outline a specific line of therapy. • Prognosis of DHF is as poor as that of systolic failure and if left undetected the mortality is as high as in systolic heart failure.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Prevalence ; Associated Factors ; Diastolic Heart Failure Elderly ; Congestive Heart Failure. |
| Subjects: | MEDICAL > Geriatrics |
| Depositing User: | Subramani R |
| Date Deposited: | 04 Apr 2018 12:02 |
| Last Modified: | 04 Apr 2018 12:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6833 |
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