Assessment of Heart Failure

  • James B. Young


The clinical syndrome of heart failure may result from cardiac disease of many different etiologies. It reflects both the primary hemodynamic abnormalities caused by cardiac dysfunction and the consequences of multiple secondary compensatory systems (eg, vasoconstriction, neurohormonal activation, metabolic imbalance). Not surprisingly, the clinical manifestations of heart failure show a striking heterogeneity and, consequently, the clinical assessment of patients with heart failure is among the most challenging in medicine [1–3].


Heart Failure Congestive Heart Failure Heart Failure Patient Brain Natriuretic Peptide Brain Natriuretic Peptide Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Young JB, Farmer JA: The diagnostic evaluation of patients with heart failure. In Congestive Heart Failure: Pathophysiology, Diagnosis, and Comprehensive Approach to Management. Edited by Hosenpud JD, Greenberg BH. New York: Springer-Verlag; 1994: 597–621.CrossRefGoogle Scholar
  2. 2.
    Badgett RG, Lucey CR, Mujrow CD: Can the clinical examination diagnose left sided heart failure in adults? JAMA 1997, 277: 1712–1719.PubMedCrossRefGoogle Scholar
  3. 3.
    Tresch DD: The clinical diagnosis of heart failure in older patients. J Am Geriatr Soc 1997, 45: 1128–1133.PubMedGoogle Scholar
  4. 4.
    Cohn JN: Jugular venous pressure monitoring: a lost art? J Cardiac Failure 1997, 3: 71–73.CrossRefGoogle Scholar
  5. 5.
    McGee SR: Physical examination of venous pressure: a critical review. Am Heart J 1998, 136: 10–18.PubMedCrossRefGoogle Scholar
  6. 6.
    Armstrong PW, Moe GW: Medical advances in the treatment of congestive heart failure. Circulation 1994, 88: 2941–2952.CrossRefGoogle Scholar
  7. 7.
    Cohn JN: The prevention of heart failure: a new agenda [editorial]. N Engl J Med 1992, 327: 725–726.PubMedCrossRefGoogle Scholar
  8. 8.
    Feldman AM: Can we alter survival in patients with congestive heart failure? JAMA 1992, 267: 1956–1961.PubMedCrossRefGoogle Scholar
  9. 9.
    Parrish DL, Grayburn PA: Use of echocardiography in patients with congestive heart failure. Cardiol Rev 1998, 6: 203–212.PubMedCrossRefGoogle Scholar
  10. Cowie MR, Struthers AD, Wood DA, et al Volume of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet 1997, 350:1349–1353.Google Scholar
  11. 11.
    Gaasch WH: Diagnosis and treatment of heart failure based on left ventricular systolic or diastolic dysfunction. JAMA 1994, 271: 1276–1280.PubMedCrossRefGoogle Scholar
  12. 12.
    Ghali JK, Cooper R, Ford E: Trends in hospitalization rates for heart failure in the United States, 1973–1986. Arch Intern Med 1992, 152: 649–655.PubMedCrossRefGoogle Scholar
  13. 13.
    Kannel WB, Belanger AJ: Epidemiology of heart failure. Am Heart J 1991, 121: 951–957.PubMedCrossRefGoogle Scholar
  14. McKee PA, Castelli WP, McNamara PM, et al The natural history of congestive heart failure: the Framingham Study. N Engl J Med 1971, 285:1441–1446.Google Scholar
  15. 15.
    Maisel A: B-type natriuretic peptide levels: a potential novel “white count” for congestive heart failure. J Card Fail 2001, 7: 183–193.PubMedCrossRefGoogle Scholar
  16. Kazanegra R, Cheng V, Garcia A, et al A rapid test for B-type natriuretic peptide correlates with falling wedge pressures in patients treated for decompensated heart failure: a pilot study. J Card Fail 2001, 7:21–29.Google Scholar
  17. Cheng V, Kazanegra R, Garcia A, et al A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure. J Am Coll Cardiol 2001, 37:386–391.Google Scholar
  18. 18.
    The CONSENSUS Trial Study Group: Effects of enalapril on mortality in severe congestive heart failure. N Engl J Med 1987, 316: 1429–1435.Google Scholar
  19. 19.
    The SOLVD Investigators: Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992, 327: 685–691.CrossRefGoogle Scholar
  20. Pfeffer MA, Braunwald E, Moyé LA, et al Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction: results of the Survival and Ventricular Enlargement Trial. N Engl J Med 1992, 327:668–677.Google Scholar
  21. Cohn JN, Archibald DG, Ziesche S, et al Effect of vasodilator therapy on mortality in chronic congestive heart failure: results of a Veterans Administration Cooperative Study. N Engl J Med 1986, 314:1547–1552.Google Scholar
  22. 22.
    The SOLVD Investigators: Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991, 325: 293–302.CrossRefGoogle Scholar
  23. Packer M, Carver JR, Rodeheffer RJ, et al Effect of oral milrinone on mortality in severe chronic heart failure. N Engl J Med 1991, 325:1468–1475.Google Scholar
  24. 24.
    Stevenson LW, Perloff JK: The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA 1989, 261: 884–888.PubMedCrossRefGoogle Scholar
  25. Szlachcic J, Massie BM, Kramer BL, et al Correlates and prognostic implication of exercise capacity in chronic congestive heart failure. Am J Cardiol 1985, 55:1037–1042.Google Scholar
  26. Young JB, Weiner DH, Pratt CM, et al Relationship of ejection fraction and symptomatic status to medication use in patients with heart failure: a report from Studies of Left Ventricular Dysfunction (SOLVD) Registry. South Med J 1994, 88:414–423.Google Scholar
  27. 27.
    Zema MJ, Caccovano M, Kligfield P: Detection of left ventricular dysfunction in ambulatory subjects with the bedside Valsalva maneuver. Am J Med 1983, 75: 241–248.PubMedCrossRefGoogle Scholar
  28. Zema MJ, Restivo Bernard, Sos T, et al Left ventricular dysfunction: bedside Valsalva manoeuvre. Br Heart J 1980, 44:560–590.Google Scholar
  29. 29.
    Zema MJ, Masters AP, Margouleff D: Dyspnea: the heart or the lungs? Differentiation at bedside by use of the simple Valsalva maneuver. Chest 1984, 85: 59–64.PubMedCrossRefGoogle Scholar
  30. 30.
    Ewy GA: The abdominojugular test: technique and hemodynamic correlates. Ann Intern Med 1988, 109: 456–460.PubMedCrossRefGoogle Scholar
  31. Butman SM, Ewy GA, Standen JR, et al Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. J Am Coll Cardiol 1993, 22:968–974.Google Scholar
  32. 32.
    Gahli JK, Kadakia S, Cooper RS, Liao Y: Bedside diagnosis of preserved versus impaired left ventricular systolic function in heart failure. Am J Cardiol 1991, 67: 1002–1006.CrossRefGoogle Scholar
  33. Heckerling PS, Wiener SL, Wolfkiel CJ, et al Accuracy and reproducibility of precordial percussion and palpation for detecting increased left ventricular end-diastolic volume and mass: a comparison of physical findings and ultrafast computed tomography of the heart. JAMA 1993, 270:1943–1948.Google Scholar
  34. Chakko S, Woska D, Martinez H, et al Clinical, radiographic, and hemodynamic correlations in chronic congestive heart failure: conflicting results may lead to inappropriate care. Am J Med 1991, 90:353–359.Google Scholar
  35. 35.
    Goldman L, Hashimoto B, Cook EF, Loscalzo A: Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation 1981, 64: 1227–1234.PubMedCrossRefGoogle Scholar
  36. Remes J, Miettinen H, Reunanen A, et al Validity of clinical diagnosis of heart failure in primary health care. Eur Heart J 1991, 12:315–321.Google Scholar
  37. 37.
    Packer M: Clinical trials in congestive heart failure: why do studies report conflicting results [editorial]? Ann Intern Med 1988, 109: 3–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Marantz PR, Alderman MH, Tobin JN: Diagnostic heterogeneity in clinical trials for congestive heart failure. Ann Intern Med 1988, 109: 55–61.PubMedCrossRefGoogle Scholar
  39. 39.
    Morris CK, Ueshima K, Kawaguchi T, et al The prognostic value of exercise capacity: a review of the literature. Am Heart J 1991, 122:1423–1431.Google Scholar
  40. 40.
    Mancini DM, Eisen H, Kussmaul W, et al Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation 1991, 83:778–786.Google Scholar
  41. 41.
    Mills RM Jr, Haught WH: Evaluation of heart failure patients: objective parameters to assess functional capacity. Clin Cardiol 1996, 19: 455–460.PubMedCrossRefGoogle Scholar
  42. 42.
    Stevenson LW: Tailored therapy to hemodynamic goals for advanced heart failure. Eur J Heart Failure 1999, 1: 251–257.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2005

Authors and Affiliations

  • James B. Young

There are no affiliations available

Personalised recommendations