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.