Signs for early diagnosis of heart failure in primary health care

Figures & data

Table 1 Symptoms and clinical signs for patients with and without heart failure

	Heart failure (n = 557) n (%)	No heart failure (n = 197) n (%)	P value	Sens	Spec	PPV	NPV
Nocturnal dyspnea	143 (26)	22 (11)	<0.001	0.26	0.89	0.87	0.30
Orthopnea	258 (46)	43 (22)	<0.001	0.46	0.78	0.86	0.34
Limitations of physical activity	334 (60)	72 (37)	<0.001	0.60	0.64	0.82	0.36
Breathlessness on exercise	372 (67)	74 (38)	<0.001	0.67	0.62	0.83	0.40
Fatigue	258 (46)	55 (28)	<0.001	0.46	0.72	0.82	0.32
Other symptoms	65 (12)	25 (13)	0.70	0.12	0.87	0.72	0.26
Third heart sound	58 (10)	6 (3)	0.001	0.10	0.97	0.91	0.28
Cardiac murmurs	123 (22)	25 (13)	0.004	0.22	0.87	0.83	0.28
Pleural effusion	128 (23)	22 (11)	<0.001	0.23	0.89	0.85	0.29
Pulmonary rales	344 (62)	64 (33)	<0.001	0.62	0.68	0.84	0.38
Raised jugular venous pressure	145 (26)	19 (10)	<0.001	0.26	0.90	0.88	0.30
Hepatomegaly	87 (16)	8 (4)	<0.001	0.16	0.96	0.92	0.29
Peripheral edema	381 (68)	70 (36)	<0.001	0.68	0.65	0.85	0.42
Other clinical signs	89 (16)	20 (10)	0.046	0.16	0.90	0.82	0.27

Abbreviations: PPV, positive predictive value; NPV, negative predictive value.

Table 2 Logistic regression stepwise backwards (last step) with the diagnosis of heart failure as independent variable and the different symptoms and clinical signs as dependent variables

	Unstandardized coefficients		Standard coefficients	t	P value	95% confidence interval for B
	B	Standard error	Beta			Lower bound	Upper bound
Orthopnea	0.07	0.03	0.08	2.05	0.040	0.01	0.13
Limitations of physical activity	0.09	0.03	0.10	3.02	0.003	0.03	0.15
Breathlessness on exercise	0.12	0.03	0.14	3.90	<0.001	0.06	0.18
Third heart sound	0.10	0.05	0.06	1.94	0.053	−0.01	0.20
Pulmonary rales	0.14	0.03	0.15	4.26	<0.001	0.07	0.20
Raised jugular venous pressure	0.08	0.04	0.07	2.07	0.039	0.01	0.15
Peripheral edema	0.20	0.03	0.22	6.54	<0.001	0.14	0.26
Others clinical signs	0.11	0.04	0.09	2.99	<0.001	0.03	0.19

Notes: Logistic regression within the first step gender, age, nocturnal dyspnea, orthopnea, limitations of physical activity, breathlessness on exercise, fatigue, other symptoms, third heart sound, cardiac murmurs, pleural effusion, pulmonary rales, raised jugular venous pressure, hepatomegaly, peripheral edema, and other clinical signs.