Asymptomatic systolic and diastolic dysfunction in patients with risk factors referred for echocardiography. The DAVES study by the Italian Society of Cardiovascular Echography.

Objectives This study aims to determine the prevalence of left ventricular dysfunction in subjects without signs and symptoms of heart failure referred for echocardiography essentially for the presence of one or more cardiovascular risk factors. Materials and methods The DAVES study (Disfunzione Asintomatica del Ventricolo Sinistro, left ventricular asymptomatic dysfunction) is a multicenter cross-sectional observational study based on echocardiography. Among 16,099 screened subjects from 75 Centers, we enrolled 3,537 subjects without signs or symptoms of heart failure. The prevalence of depressed left ventricular systolic (left ventricular ejection fraction ≤ 50%) and diastolic function was analyzed. Results The overall prevalence of asymptomatic left ventricular systolic dysfunction was 9.4%, while diastolic dysfunction was detected in 39.1% of subjects. The rate of systolic and diastolic dysfunction increased proportionally to the number of cardiovascular risk factors (1 or ≥ 5 risk factors), ranging from 8.1% to 27.1% and from 37.5% to 45.0%, respectively. At multivariate analysis, independent variables predictive for systolic dysfunction were male gender (p<0.001), family history of cardiovascular disease (p=0.002) and diabetes (p=0.027); while for diastolic dysfunction they were age (p<0.001), hypertension (p<0.001) and diabetes (p<0.05). Conclusions In a large sample of subjects without symptoms of heart failure referred to echocardiography, we found a significant prevalence of left ventricular systolic and diastolic dysfunction, both related to the number of cardiovascular risk factors.