Natriuretic peptides and the Framingham Risk score for screening of asymptomatic left ventricular systolic dysfunction in high-risk patients in primary care. The DAVID-BERG study

摘要

Asymptomatic left ventricular systolic dysfunction (ALVSD), or stage B heart failure (HF), is associated with increased cardiovascular (CV) and all-cause mortality, and nonfatal CV events [1,2]. ALVSD is distinctly more common among subjects with stage A HF [3].ALVSD remains commonly underdiagnosed, particularly in primary care, where diagnostic facilities are limited. Routine echocardiography, the diagnostic gold standard for ALVSD, is not the screening strategy of choice due to lack of accessibility and cost. Alternative approaches using risk scores and biomarkers have been proposed. The Framingham HF risk score (FHFRS) score [4] is a gender-specific risk stratification tool to identify patients at high risk of developing HF within 4 years. Natriuretic peptides (NP) have been evaluated as screening tools for further evaluation in several studies and showed prognostic value in stage A/B patients.