Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: The INDYCE registry

Summary Background The distribution of left ventricular ejection fraction (LVEF) – a key factor in coronary artery disease (CAD) patient management and prognostication – is poorly documented. Objective To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients i...

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Veröffentlicht in:Archives of cardiovascular diseases 2010-06, Vol.103 (6), p.354-362
Hauptverfasser: Tabet, Jean-Yves, Malergue, Marie-Christine, Guenoun, Maxime, Paganelli, Franck, Meurin, Philippe, Not, Didier, Jourdain, Patrick, Guedj-Meynier, Dominique
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container_end_page 362
container_issue 6
container_start_page 354
container_title Archives of cardiovascular diseases
container_volume 103
creator Tabet, Jean-Yves
Malergue, Marie-Christine
Guenoun, Maxime
Paganelli, Franck
Meurin, Philippe
Not, Didier
Jourdain, Patrick
Guedj-Meynier, Dominique
description Summary Background The distribution of left ventricular ejection fraction (LVEF) – a key factor in coronary artery disease (CAD) patient management and prognostication – is poorly documented. Objective To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France. Methods The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded. Results Overall, 3119 patients (68.4 ± 11.0 years; 80% men) were enrolled. LVEF was 56.1 ± 11.8% on average, and was poor (< 40%) and moderately impaired (40–50%) in 9.6% ( n = 298) and 19.8% ( n = 619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class ≤ I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59–5.63; P < 0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration. Conclusion Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR ≥ 70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.
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Objective To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France. Methods The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded. Results Overall, 3119 patients (68.4 ± 11.0 years; 80% men) were enrolled. LVEF was 56.1 ± 11.8% on average, and was poor (&lt; 40%) and moderately impaired (40–50%) in 9.6% ( n = 298) and 19.8% ( n = 619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class ≤ I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59–5.63; P &lt; 0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration. Conclusion Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR ≥ 70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2010.05.002</identifier><identifier>PMID: 20800799</identifier><language>eng</language><publisher>Amsterdam: Elsevier Masson SAS</publisher><subject>Aged ; Aged, 80 and over ; Angina ; Angor ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure ; Cardiology. Vascular system ; Cardiopathie ischémique ; Cardiovascular ; Cardiovascular Agents - therapeutic use ; Cardiovascular system ; Chi-Square Distribution ; Coronary artery disease ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - drug therapy ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - physiopathology ; Coronary heart disease ; Cross-Sectional Studies ; Female ; Fraction d’éjection ventriculaire gauche ; France - epidemiology ; Heart ; Heart Rate ; Humans ; Internal Medicine ; Investigative techniques of hemodynamics ; Investigative techniques, diagnostic techniques (general aspects) ; Left ventricular ejection fraction ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Outpatients ; Prospective Studies ; Registries ; Stroke Volume ; Treatment Outcome ; Ultrasonography ; Ventricular Function, Left</subject><ispartof>Archives of cardiovascular diseases, 2010-06, Vol.103 (6), p.354-362</ispartof><rights>Elsevier Masson SAS</rights><rights>2010 Elsevier Masson SAS</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c484t-a7e3670069388bbffd5dd0709a622de699b2e024f8dca772a9802a551cc0e5ff3</citedby><cites>FETCH-LOGICAL-c484t-a7e3670069388bbffd5dd0709a622de699b2e024f8dca772a9802a551cc0e5ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acvd.2010.05.002$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=23175887$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20800799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tabet, Jean-Yves</creatorcontrib><creatorcontrib>Malergue, Marie-Christine</creatorcontrib><creatorcontrib>Guenoun, Maxime</creatorcontrib><creatorcontrib>Paganelli, Franck</creatorcontrib><creatorcontrib>Meurin, Philippe</creatorcontrib><creatorcontrib>Not, Didier</creatorcontrib><creatorcontrib>Jourdain, Patrick</creatorcontrib><creatorcontrib>Guedj-Meynier, Dominique</creatorcontrib><creatorcontrib>on behalf of the Collège national des cardiologues français (CNCF)</creatorcontrib><creatorcontrib>Collège national des cardiologues français (CNCF)</creatorcontrib><title>Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: The INDYCE registry</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>Summary Background The distribution of left ventricular ejection fraction (LVEF) – a key factor in coronary artery disease (CAD) patient management and prognostication – is poorly documented. Objective To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France. Methods The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded. Results Overall, 3119 patients (68.4 ± 11.0 years; 80% men) were enrolled. LVEF was 56.1 ± 11.8% on average, and was poor (&lt; 40%) and moderately impaired (40–50%) in 9.6% ( n = 298) and 19.8% ( n = 619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class ≤ I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59–5.63; P &lt; 0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration. Conclusion Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR ≥ 70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angina</subject><subject>Angor</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood Pressure</subject><subject>Cardiology. Vascular system</subject><subject>Cardiopathie ischémique</subject><subject>Cardiovascular</subject><subject>Cardiovascular Agents - therapeutic use</subject><subject>Cardiovascular system</subject><subject>Chi-Square Distribution</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - drug therapy</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary heart disease</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Fraction d’éjection ventriculaire gauche</subject><subject>France - epidemiology</subject><subject>Heart</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Investigative techniques of hemodynamics</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Left ventricular ejection fraction</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Outpatients</subject><subject>Prospective Studies</subject><subject>Registries</subject><subject>Stroke Volume</subject><subject>Treatment Outcome</subject><subject>Ultrasonography</subject><subject>Ventricular Function, Left</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks2O0zAQxyMEYpeFF-CAfEGcWsZOEzsIIaHuAiut4MBy4GQ59pg6pHGxk0p9AN6bCS2LxIGTRzP_-fp5iuIphyUHXr_slsbu3VIAOaBaAoh7xTlXsloILtT9O7usz4pHOXcAtZCyflicCVAAsmnOi5-XIY8ptNMY4sCiZz36ke1xIKedepMYdmh_B30yR8MMjm3QpJElMyLbm37CzAIFmI2bSH6qk0fT9kiOFAeTDmxnxkBV8yt2u0F2_fHy6_qKJfw2tz88Lh5402d8cnovii_vrm7XHxY3n95fr9_eLOxKrcaFkVjWktZoSqXa1ntXOQcSGlML4bBumlYgiJVXzhophWkUCFNV3FrAyvvyonhxrLtL8QcNPeptyBb73gwYp6xltQKCphQpxVFpU8w5ode7FLa0iOagZ_q60zN9PdPXUGmiT0nPTuWndovuLuUPbhI8PwlMtqYnooMN-a-u5LJSSpLu9VGHBGMfMOlsiZ5FFxL9hnYx_H-ON_-k2z4MgTp-xwPmLk5pIMya6yw06M_zncxnwgGA8xLKX3lDuVc</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Tabet, Jean-Yves</creator><creator>Malergue, Marie-Christine</creator><creator>Guenoun, Maxime</creator><creator>Paganelli, Franck</creator><creator>Meurin, Philippe</creator><creator>Not, Didier</creator><creator>Jourdain, Patrick</creator><creator>Guedj-Meynier, Dominique</creator><general>Elsevier Masson SAS</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: The INDYCE registry</title><author>Tabet, Jean-Yves ; Malergue, Marie-Christine ; Guenoun, Maxime ; Paganelli, Franck ; Meurin, Philippe ; Not, Didier ; Jourdain, Patrick ; Guedj-Meynier, Dominique</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c484t-a7e3670069388bbffd5dd0709a622de699b2e024f8dca772a9802a551cc0e5ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angina</topic><topic>Angor</topic><topic>Atherosclerosis (general aspects, experimental research)</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood Pressure</topic><topic>Cardiology. Vascular system</topic><topic>Cardiopathie ischémique</topic><topic>Cardiovascular</topic><topic>Cardiovascular Agents - therapeutic use</topic><topic>Cardiovascular system</topic><topic>Chi-Square Distribution</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - drug therapy</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary heart disease</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Fraction d’éjection ventriculaire gauche</topic><topic>France - epidemiology</topic><topic>Heart</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Investigative techniques of hemodynamics</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Left ventricular ejection fraction</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Outpatients</topic><topic>Prospective Studies</topic><topic>Registries</topic><topic>Stroke Volume</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tabet, Jean-Yves</creatorcontrib><creatorcontrib>Malergue, Marie-Christine</creatorcontrib><creatorcontrib>Guenoun, Maxime</creatorcontrib><creatorcontrib>Paganelli, Franck</creatorcontrib><creatorcontrib>Meurin, Philippe</creatorcontrib><creatorcontrib>Not, Didier</creatorcontrib><creatorcontrib>Jourdain, Patrick</creatorcontrib><creatorcontrib>Guedj-Meynier, Dominique</creatorcontrib><creatorcontrib>on behalf of the Collège national des cardiologues français (CNCF)</creatorcontrib><creatorcontrib>Collège national des cardiologues français (CNCF)</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tabet, Jean-Yves</au><au>Malergue, Marie-Christine</au><au>Guenoun, Maxime</au><au>Paganelli, Franck</au><au>Meurin, Philippe</au><au>Not, Didier</au><au>Jourdain, Patrick</au><au>Guedj-Meynier, Dominique</au><aucorp>on behalf of the Collège national des cardiologues français (CNCF)</aucorp><aucorp>Collège national des cardiologues français (CNCF)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: The INDYCE registry</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>103</volume><issue>6</issue><spage>354</spage><epage>362</epage><pages>354-362</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Summary Background The distribution of left ventricular ejection fraction (LVEF) – a key factor in coronary artery disease (CAD) patient management and prognostication – is poorly documented. Objective To determine LVEF and heart rate (HR) values, and describe the management of stable CAD patients in France. Methods The INDYCE survey was a prospective, multicentre registry of consecutive stable CAD outpatients attending a cardiology consultation. The survey focused on LVEF values measured using the echocardiographic Simpson biplane method. Drug therapy, resting HR, blood pressure and symptoms were also recorded. Results Overall, 3119 patients (68.4 ± 11.0 years; 80% men) were enrolled. LVEF was 56.1 ± 11.8% on average, and was poor (&lt; 40%) and moderately impaired (40–50%) in 9.6% ( n = 298) and 19.8% ( n = 619) of cases, respectively. Symptomatic angina pectoris was present in 19.2% of cases and only 40.6% of patients were asymptomatic (no angina and NYHA class ≤ I) despite relatively aggressive management (79.0% of patients had undergone coronary angioplasty and/or bypass graft). Interestingly, 14.1% of patients with LVEF less than 40% were asymptomatic. In multivariable analysis, LVEF less than 40% was associated most strongly with symptomatic status (odds ratio 3.82; 95% CI 2.59–5.63; P &lt; 0.0001), together with female sex, age greater than 75 years, diabetes, HR greater or equal to 70 bpm, sedentariness, obesity and disease duration. Conclusion Only 9.6% of stable CAD patients had severe left ventricular dysfunction; among them, 14.1% were strictly asymptomatic. This could justify regular LVEF measurement in CAD patients. Three potentially reversible factors (HR ≥ 70 bpm, being overweight and sedentariness) were linked independently to the presence of symptoms.</abstract><cop>Amsterdam</cop><pub>Elsevier Masson SAS</pub><pmid>20800799</pmid><doi>10.1016/j.acvd.2010.05.002</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Angina
Angor
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Cardiology. Vascular system
Cardiopathie ischémique
Cardiovascular
Cardiovascular Agents - therapeutic use
Cardiovascular system
Chi-Square Distribution
Coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - drug therapy
Coronary Artery Disease - epidemiology
Coronary Artery Disease - physiopathology
Coronary heart disease
Cross-Sectional Studies
Female
Fraction d’éjection ventriculaire gauche
France - epidemiology
Heart
Heart Rate
Humans
Internal Medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Left ventricular ejection fraction
Logistic Models
Male
Medical sciences
Middle Aged
Outpatients
Prospective Studies
Registries
Stroke Volume
Treatment Outcome
Ultrasonography
Ventricular Function, Left
title Distribution of left ventricular ejection fraction and heart rate values in a cohort of stable coronary patients: The INDYCE registry
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