Screening echocardiograms in a senior focused value based primary care improves systolic heart failure detection & clinical management

Reyan Ghany, Leonardo Tamariz, Gordon Chen, Alina Ghany, Emancia Forbes, Thiago Tajiri, Ana Palacio

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Screening echocardiograms are not indicated. Our aim is to evaluate the impact of screening echocardiograms on improving clinical management among older adults. Methods: We performed screening echocardiograms for all consecutive patients and defined incident systolic heart failure (HF) as an ejection fraction of less than 50% among patients without a previous HF diagnosis. We reviewed medical record data to determine if the new cases where Stage B or C. We obtained prescribed medications and vital signs from the electronic health record to determine absolute changes before and after the echocardiogram. Results: We performed an echocardiogram in 6,417 patients with a mean age of 71.4±6. The echocardiogram identified 292 seniors with new cases of systolic HF (5.34%; 95% CI: 4.7-5.9) and 239 were stage B HF. The increase in the use of ace-inhibitor, beta blocker when comparing the pre and post echocardiogram periods was highest in those with Stage C and those with ejection fraction lower than 40%. Systolic blood pressure (SBP) decreased from 140±19 to 136±15 (P<0.01) and low density lipoprotein (LDL) from 105±36 to 97±33 (P<0.01). Conclusions: Performing echocardiograms in senior-focused value-based primary care improves evidence-based cardiovascular treatment and short-Term clinical outcomes, including lowering SBP and LDL.

Original languageEnglish (US)
Pages (from-to)236-243
Number of pages8
JournalCardiovascular Diagnosis and Therapy
Volume7
Issue number3
DOIs
StatePublished - Jun 1 2017

Keywords

  • Echocardiogram
  • Elderly
  • Heart failure (HF)
  • Screening

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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