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Federal government websites often end in. The site is secure. Preview improvements coming to the PMC website in October Learn More or Try it out now. Contributors: OWN initiated and coordinated the primary study hypothesis, discussed core ideas, designed the protocol, collected the data, performed the analyses, and wrote the paper. JFH discussed core ideas and design and participated in clinical analyses and writing of the paper.

JH discussed core ideas and design and participated in statistical analyses and writing the paper. CTL supervised the echocardiography, participated in a reproducibility study, and edited the paper. JS analysed natriuretic peptide and edited the paper. To assess the probability of left ventricular systolic dysfunction without echocardiography in patients from general practice.

Cross sectional study using multivariate regression models to examine the relation between clinical variables and left ventricular systolic dysfunction as determined by echocardiography. The prevalence was significantly related to three questions: does the electrocardiogram have Q waves, left bundle branch block, or ST-T segment changes?

A normal electrocardiogram implies a low risk of left ventricular systolic dysfunction. Patients can be identified for echocardiography on the basis of an abnormal electrocardiogram combined with increased natriuretic peptide concentration or a heart rate greater than diastolic blood pressure, or both. Identification and treatment of patients with left ventricular systolic dysfunction improves survival and reduces morbidity. Identification consequently rests on selecting the right patients for echocardiography.