Chronic Congestive Heart Failure in Coronary Artery Disease: Clinical Criteria

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Abstract
Congestive heart failure is a frequent and important manifestation of cardiovascular disease, but no uniform clinical criteria are available for use in epidemiologic studies. To develop diagnostic criteria, pertinent clinical findings were related to physiologic measures of left ventricular function in patients with coronary artery disease. When left ventricular end diastolic pressure or arteriovenous O2 difference was used as the physiologic criterion, the following variables contributed significant (P < 0.01) information: heart volume, ventricular gallop, heart rate, and blood pressure. The most reliable and valid set of descriptors determined in 1 group was tested in a 2nd group of 1306 patients who were followed for 6-36 mo. after initial evaluation. The validity of the descriptors was confirmed, and patients identified as having heart failure by these criteria experienced a worse survival rate (P < 0.001). These criteria characterize patients likely to have impaired left ventricular function and a greater risk of death.

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