Therelationship between left ventricular systolic function andcongestive heartfailure diagnosed byclinical criteria

There isnouniformly accepted clinical definition forcongestive heart failure (CHF), although criteria havebeenpublished byvarious groups.There isalso noreference standard forCHF, although left ventricular ejection fraction (LVEF) gives aquantitative assessment ofsystolic function andisuseful inpredicting prognosis. Todetermine therelationship between LVEFandclinically diagnosed CHF,we compared resting LVEFdetermined byradionuclide ventriculography with diagnosis ofCHFbyclinical criteria in407patients, based onclinical data collected byacardiology fellow. Of153patients witha lowLVEF(s0.40), 30(20%)metnone ofthecriteria forCHF. Conversely, of204patients withnormal LVEF(.0.50), 105(51%) metatleast oneofthecriteria. Weconclude that different criteria forCHFwill havevarying utility depending onthepopulation being examined, andthat acombination ofclinical features andanobjective measureofcardiac performance isneeded todiagnose CHF. Circulation 77,No.3,607-612, 1988. CONGESTIVEHEARTFAILUREisamongthemost frequently encountered cardiac diagnoses. Prevalence