{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:41:36Z","timestamp":1788176496434,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2014,4,26]],"date-time":"2014-04-26T00:00:00Z","timestamp":1398470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to determine the prevalence of left ventricular systolic dysfunction (LVSD) in outpatients with peripheral atherosclerotic vascular disease (PAVD). Further, the associations of stenotic internal carotid artery disease (SICAD) and lower extremity artery disease (LEAD) with LVSD were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In the Peripheral Artery Disease in V\u00e4stmanland study, consecutive outpatients with ultrasonographically identified mild to severe stenosis in the internal carotid artery or symptoms of claudication combined with either ankle brachial index of \u22640.90 or ultrasonographic occlusive findings were included (n\u2009=\u2009437). Population-based control subjects were matched to the patients (n\u2009=\u2009395). LVSD was defined as echocardiographically determined left ventricular ejection fraction (LVEF) &amp;lt;55%, and moderate or greater LVSD was defined as LVEF &amp;lt;45%. The prevalence of LVSD was significantly greater in patients than in controls (13.7% vs. 6.1%, P\u2009&amp;lt;\u20090.001). The prevalence of moderate or greater LVSD in participants not on treatment with a combination of angiotensin-converting enzyme inhibitor and beta-blocker was 2.3% in patients and 1.3% in controls (P\u2009=\u20090.31). When LEAD and SICAD were analysed together, adjusted for potential confounders, SICAD [odds ratio (OR) 2.54, 95% confidence interval (CI) 1.03\u20136.32], but not LEAD (OR 1.59, 95% CI 0.80\u20133.18), was independently associated with LVSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In outpatients with PAVD, we found a 13.7% prevalence of LVSD. However, the prevalence of at least moderate LVSD in patients not on treatment with angiotensin-converting enzyme inhibitor and a beta-blocker was only 2.3% and not significantly different from controls. Stenotic artery disease in the internal carotid artery, but not in the lower extremities, was independently associated with LVSD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.95","type":"journal-article","created":{"date-parts":[[2014,4,26]],"date-time":"2014-04-26T07:33:13Z","timestamp":1398497593000},"page":"625-632","source":"Crossref","is-referenced-by-count":25,"title":["Left Ventricular Systolic Dysfunction in Outpatients with Peripheral Atherosclerotic Vascular Disease: Prevalence and Association with Location of Arterial Disease"],"prefix":"10.1093","volume":"16","author":[{"given":"P\u00e4r","family":"Hedberg","sequence":"first","affiliation":[{"name":"Department of Clinical Physiology, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]},{"name":"Center for Clinical Research, University of Uppsala, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotta","family":"Hammar","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Department of Cardiology, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Selmeryd","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]},{"name":"Center for Clinical Research, University of Uppsala, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefin","family":"Viklund","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Department of Cardiology, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy","family":"Leppert","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, University of Uppsala, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Hellberg","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egil","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology, V\u00e4stmanland County Hospital , V\u00e4ster\u00e5s ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,4,26]]},"reference":[{"key":"2026011921115585400_ejhf95-bib-0001","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1161\/01.CIR.0000085166.44904.79","article-title":"Natural history of asymptomatic left ventricular systolic dysfunction in the community","volume":"108","author":"Wang","year":"2003","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0002","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1001\/jama.289.2.194","article-title":"Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic","volume":"289","author":"Redfield","year":"2003","journal-title":"JAMA"},{"key":"2026011921115585400_ejhf95-bib-0003","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1161\/CIRCULATIONAHA.112.112201","article-title":"Prognosis of individuals with asymptomatic left ventricular systolic dysfunction in the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"126","author":"Yeboah","year":"2012","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0004","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1056\/NEJM199209033271003","article-title":"Investigators. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions","volume":"327","author":"The","year":"1992","journal-title":"N Engl J Med"},{"key":"2026011921115585400_ejhf95-bib-0005","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1056\/NEJM199209033271001","article-title":"Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the Survival and Ventricular Enlargement trial. The SAVE Investigators","volume":"327","author":"Pfeffer","year":"1992","journal-title":"N Engl J Med"},{"key":"2026011921115585400_ejhf95-bib-0006","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/eurjhf\/hfs105","article-title":"ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC","volume":"14","author":"McMurray","year":"2012","journal-title":"Eur J Heart Fail"},{"key":"2026011921115585400_ejhf95-bib-0007","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1161\/CIRCULATIONAHA.109.192064","article-title":"2009 focused update: ACCF\/AHA guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on practice guidelines. Developed in collaboration with the International Society for Heart and Lung Transplantation","volume":"119","author":"Jessup","year":"2009","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0008","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.jacc.2003.10.043","article-title":"Cost-effectiveness of screening with B-type natriuretic peptide to identify patients with reduced left ventricular ejection fraction","volume":"43","author":"Heidenreich","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"2026011921115585400_ejhf95-bib-0009","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1161\/CIR.0b013e31823299a1","article-title":"2012 ACCF\/AHA\/ACR\/SCAI\/SIR\/STS\/SVM\/SVN\/SVS key data elements and definitions for peripheral atherosclerotic vascular disease","volume":"125","author":"Creager","year":"2012","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0010","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1056\/NEJM199403103301002","article-title":"Dipyridamole-thallium scintigraphy and gated radionuclide angiography to assess cardiac risk before abdominal aortic surgery","volume":"330","author":"Baron","year":"1994","journal-title":"N Engl J Med"},{"key":"2026011921115585400_ejhf95-bib-0011","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/00000658-198402000-00016","article-title":"Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management","volume":"199","author":"Hertzer","year":"1984","journal-title":"Ann Surg"},{"key":"2026011921115585400_ejhf95-bib-0012","first-page":"77","article-title":"Preoperative cardiac screening before peripheral vascular operations","volume":"51","author":"Jain","year":"1985","journal-title":"Am Surg"},{"key":"2026011921115585400_ejhf95-bib-0013","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0735-1097(01)01725-9","article-title":"The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: a case\u2013control study","volume":"39","author":"Kelly","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"2026011921115585400_ejhf95-bib-0014","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.amjcard.2006.09.102","article-title":"Comparison of the frequency of abnormal cardiac findings by echocardiography in patients with and without peripheral arterial disease","volume":"99","author":"Ward","year":"2007","journal-title":"Am J Cardiol"},{"key":"2026011921115585400_ejhf95-bib-0015","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.echo.2005.01.004","article-title":"High prevalence of important cardiac findings in patients with peripheral arterial disease referred for echocardiography","volume":"18","author":"Ward","year":"2005","journal-title":"J Am Soc Echocardiogr"},{"key":"2026011921115585400_ejhf95-bib-0016","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.echo.2010.08.021","article-title":"The distinct relationships of carotid plaque disease and carotid intima-media thickness with left ventricular function","volume":"23","author":"Chahal","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"key":"2026011921115585400_ejhf95-bib-0017","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1161\/ATVBAHA.109.193490","article-title":"Carotid intima-media thickness, systemic inflammation, and incidence of heart failure hospitalizations","volume":"29","author":"Engstr\u00f6m","year":"2009","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2026011921115585400_ejhf95-bib-0018","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/euhj.1999.2006","article-title":"Prognostic implications of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris","volume":"22","author":"Held","year":"2001","journal-title":"Eur Heart J"},{"key":"2026011921115585400_ejhf95-bib-0019","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1161\/01.CIR.0000112642.63927.54","article-title":"Relationship of high and low ankle\u2013brachial index to all-cause and cardiovascular disease mortality: the Strong Heart Study","volume":"109","author":"Resnick","year":"2004","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0020","first-page":"e584","article-title":"2010 ACCF\/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines","volume":"122","author":"Greenland","year":"2010","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0021","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1148\/radiol.2292030516","article-title":"Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis \u2013 Society of Radiologists in Ultrasound Consensus Conference","volume":"229","author":"Grant","year":"2003","journal-title":"Radiology"},{"key":"2026011921115585400_ejhf95-bib-0022","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.euje.2005.12.014","article-title":"Recommendations for chamber quantification","volume":"7","author":"Lang","year":"2006","journal-title":"Eur J Echocardiogr"},{"key":"2026011921115585400_ejhf95-bib-0023","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1161\/01.CIR.88.1.107","article-title":"Survival after the onset of congestive heart failure in Framingham Heart Study subjects","volume":"88","author":"Ho","year":"1993","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0024","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Int Med"},{"key":"2026011921115585400_ejhf95-bib-0025","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1056\/NEJM199403103301002","article-title":"Dipyridamole-thallium scintigraphy and gated radionuclide angiography to assess cardiac risk before abdominal aortic surgery","volume":"330","author":"Baron","year":"1994","journal-title":"N Engl J Med"},{"key":"2026011921115585400_ejhf95-bib-0026","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1136\/heartjnl-2012-303216","article-title":"Aging of the population may not lead to an increase in the numbers of acute coronary events: a community surveillance study and modelled forecast of the future","volume":"99","author":"Salomaa","year":"2013","journal-title":"Heart"},{"key":"2026011921115585400_ejhf95-bib-0027","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1161\/CIRCULATIONAHA.111.047480","article-title":"Twenty-two-year trends in incidence of myocardial infarction, coronary heart disease mortality, and case fatality in 4 US communities, 1987\u20132008","volume":"125","author":"Rosamond","year":"2012","journal-title":"Circulation"},{"key":"2026011921115585400_ejhf95-bib-0028","first-page":"681","article-title":"Carotid plaque burden as a measure of subclinical atherosclerosis: comparison with other tests for subclinical arterial disease in the High Risk Plaque BioImage Study","volume":"5","author":"Sillesen","year":"2012","journal-title":"JACC: Cardiovasc Imaging"},{"key":"2026011921115585400_ejhf95-bib-0029","doi-asserted-by":"crossref","first-page":"2580","DOI":"10.1093\/eurheartj\/ehl228","article-title":"Association of ankle\u2013brachial index and plaques in the carotid and femoral arteries with cardiovascular events and total mortality in a population-based study with 13\u2009years of follow-up","volume":"27","author":"Lamina","year":"2006","journal-title":"Eur Heart J"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejhf.95","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/16\/6\/625\/66434777\/eurjhf_16_6_625.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/16\/6\/625\/66434777\/eurjhf_16_6_625.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:13:30Z","timestamp":1768875210000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/16\/6\/625\/8427742"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,26]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2014,4,26]]},"published-print":{"date-parts":[[2014,6,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ejhf.95","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2014,6]]},"published":{"date-parts":[[2014,4,26]]}}}