Volume 15, Number 1, January-February 2008

Evaluation of an open-access heart failure service spanning primary and secondary care
Kiran CR Patel, Jennifer Prince, Seema Mirza, Lucy Edmonds, Rachel Duncan, Joanna Parry, Sally Jerome, John Wozniak, Nic Anfilogoff, Michael Frenneaux, Michael K Davies

Heart failure (HF) is common and the current gold-standard diagnostic modality for left ventricular systolic dysfunction (LVSD) is transthoracic echocardiography (TTE). To comply with the National Service Framework (NSF) for Coronary Heart Disease, an open access TTE service was established and this paper reports on the diagnostic yield of LVSD and valvopathy of TTE services in that service. Diagnostic services were made available to patients from both primary and secondary care. As part of the assessment, all patients were evaluated by TTE to assess left ventricular function and any valvular pathology. Overall, 61% of patientshad normal left ventricular ejection fraction, 16% mild LVSD, 9% moderate LVSD and 14% severe LVSD. Forty-three percent of patients had no evidence of valvopathy, 31% had mild, 19% moderate and 7% severe valvopathy. Valvopathy was the primary pathology in 15.8% of patients and 13.5% had LVSD as their primary pathology: 30.4% had no valvopathy or LVSD. In the remainder, it was not possible to determine the dominant pathology causing HF due to concomitant LVSD and valvopathy. TTE has a very high diagnostic yield in both primary and secondary care. Significant levels of valvopathy and LVSD are found in populations from both primary and secondary care.

Br J Cardiol 2008;15:35-39.

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