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Many patients with a history of ischaemic heart disease (IHD) or
diabetes have left ventricular systolic dysfunction and would be
candidates for a targeted echocardiographic screening programme for
heart failure. Davis and colleagues (p 1156) investigated the
prevalence of systolic dysfunction and heart failure in patients in the
community with general practice records of one or more risk factors.
Systolic dysfunction was common in patients with a history of
myocardial infarction, moderately so in those with angina or diabetes,
but uncommon in those with uncomplicated hypertension. Formal trials of
systematic echocardiographic screening of patients with ischaemic heart
disease and diabetes should be considered.