Comparative study of systolic and diastolic cardiac failure in elderly hospitalized patients in a tertiary care hospital in Southwest India

Aims: To study and compare the clinical, echocardiographic and the aetiological features of systolic and diastolic cardiac failure in elderly patients. Methods: This is a prospective observational study done from November 2003 to October 2005. Ninety four patients aged > 60 years who satisfied the Framingham's Criteria for cardiac failure, admitted in the Medicine and Cardiology wards of Kasturba Hospital, Manipal, were included. All patients underwent echocardiographic study and the necessary evaluation to identify the aetiology of the cardiac failure. Statistical Analysis: The results thus attained, were then charted and analyzed using the SPSS 11.0 statistical software package for Windows. The comparative analysis between Group 1 and Group 2 was done using the Chi-Square test for categorical variables. Continuous variables were also categorized and analyzed using the Chi-Square test. Results: The mean age of the study group was 68.9 years ± 6.01 years. It consisted of 57 (60.63%) males and 37 (39.36%) females. Twenty eight (29.78%) patients had isolated systolic failure (Group 1) and 22 (23%) had isolated diastolic failure (Group 2). Tachycardia (p value = 0.017), cardiomegaly (p value = 0.039) and pulmonary rales (p value = 0.003) were more common in Group 1. The most common aetiology in both groups was coronary artery disease (CAD). Hypertension was more common in diastolic failure (p value = 0.010). Conclusions: This study proves that isolated diastolic failure is a significant presentation among the elderly patients presenting to our hospital. Tachycardia, cardiomegaly and pulmonary rales were more common in systolic failure as compared to diastolic failure. These result from hypertension, which can be easily screened and treated.