| Title |
Epidemiology of Left Ventricular Systolic Dysfunction and Heart Failure in the Framingham Study An Echocardiographic Study Over 3 Decades
|
|---|---|
| Published in |
JACC: Cardiovascular Imaging, October 2017
|
| DOI | 10.1016/j.jcmg.2017.08.007 |
| Pubmed ID | |
| Authors |
Ramachandran S. Vasan, Vanessa Xanthakis, Asya Lyass, Charlotte Andersson, Connie Tsao, Susan Cheng, Jayashri Aragam, Emelia J. Benjamin, Martin G. Larson |
| Abstract |
The purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation. Temporal trends in the prevalence and management of major risk factors may affect the epidemiology of HF. We compared the frequency, correlates, and prognosis of LVSD (left ventricular ejection fraction [LVEF] <50%) among Framingham Study participants without and with clinical HF in 3 decades (1985 to 1994, 1995 to 2004, and 2005 to 2014). Among participants without HF (12,857 person-observations, mean age 53 years, 56% women), the prevalence of LVSD on echocardiography decreased (3.38% in 1985 to 1994 vs. 2.2% in 2005 to 2014; p < 0.0001), whereas mean LVEF increased (65% vs. 68%; p < 0.001). The elevated risk associated with LVSD (∼2- to 4-fold risk of HF or death) remained unchanged over time. Among participants with new-onset HF (n = 894, mean age 75 years, 52% women), the frequency of heart failure with preserved ejection fraction (HFpEF) increased (preserved LVEF ≥50%: 41.0% in 1985 to 1994 vs. 56.17% in 2005 to 2014; p < 0.001) and heart failure with reduced ejection fraction (HFrEF) decreased (reduced LVEF <40%: 44.1% vs. 31.06%; p = 0.002), whereas heart failure with midrange LVEF remained unchanged (LVEF 40% to <50%: 14.9% vs. 12.77%; p = 0.66). Cardiovascular mortality associated with HFrEF declined across decades (hazard ratio: 0.61; 95% confidence interval: 0.39 to 0.97), but remained unchanged for heart failure with midrange LVEF and HFpEF. Approximately 47% of the observed increase in LVEF among those without HF and 75% of the rising proportion of HFpEF across decades was attributable to trends in risk factors, especially a decline in the prevalence of coronary heart disease among those with HF. The profile of HF in the community has changed in recent decades, with a lower prevalence of LVSD and an increased frequency of HFpEF, presumably due to concomitant risk factor trends. |
X Demographics
The data shown below were collected from the profiles of 71 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 16 | 23% |
| Spain | 13 | 18% |
| Australia | 3 | 4% |
| Venezuela, Bolivarian Republic of | 2 | 3% |
| France | 2 | 3% |
| United Kingdom | 2 | 3% |
| Canada | 1 | 1% |
| Paraguay | 1 | 1% |
| Nigeria | 1 | 1% |
| Other | 6 | 8% |
| Unknown | 24 | 34% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 42 | 59% |
| Practitioners (doctors, other healthcare professionals) | 15 | 21% |
| Scientists | 12 | 17% |
| Science communicators (journalists, bloggers, editors) | 2 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 147 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 147 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 16 | 11% |
| Student > Bachelor | 15 | 10% |
| Student > Ph. D. Student | 14 | 10% |
| Other | 13 | 9% |
| Student > Postgraduate | 12 | 8% |
| Other | 27 | 18% |
| Unknown | 50 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 53 | 36% |
| Biochemistry, Genetics and Molecular Biology | 7 | 5% |
| Nursing and Health Professions | 4 | 3% |
| Engineering | 4 | 3% |
| Agricultural and Biological Sciences | 4 | 3% |
| Other | 20 | 14% |
| Unknown | 55 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 72. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 August 2022.
All research outputs
#604,204
of 25,837,817 outputs
Outputs from JACC: Cardiovascular Imaging
#142
of 2,724 outputs
Outputs of similar age
#12,701
of 333,935 outputs
Outputs of similar age from JACC: Cardiovascular Imaging
#5
of 52 outputs
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So far Altmetric has tracked 2,724 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.1. This one has done particularly well, scoring higher than 94% of its peers.
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