Objective: The objective of this study is to determine the frequency of asymptomatic left ventricular systolic dysfunction in high risk patients.

Study Design: Cross sectional survey Setting: The study was conducted in the Department of Cardiology, Gulab Devi Hospital, Lahore. Methodology: 150 patients aged more than 50, who do not have signs and symptoms of heart failure like dyspnea on exertion, orthopnea and PND and having any 2 or more of these risk factors, Diabetes mellitus,Hypertension, IHD and Obesity were selected for this study. Each patient was asked about age, sex, diabetes mellitus, hypertension and symptoms of heart failure. Height and weight was checked and BMI was calculated in every patient. 6 minute walk test was done in every patient to rule out dyspnea on exertion. Echocardiography was performed in OPD of cardiology department. Left ventricular (LV) ejection fraction (EF) less than 50% was taken as LV systolic dysfunction.

Results: The mean age of the patients was 57.5±7.04years.There were 24 (16%) patients who had ejection fraction less than 50% and they were labeled as having left ventricular systolic dysfunction. Among these, 09 (06%) patients had ejection fraction less than 40%. Only 32 patients had ischemic heart disease, 16 of these (50%) had ALVSD. This is the highest frequency of ALVSD amongst the different risk factor groups.

Conclusion: In view of our results, we conclude that ischemic heart disease, diabetes mellitus, hypertension and obesity are important risk factors for the development of ALVSD. The frequency of ALVSD rises proportionately with increasing number of risk factors. Multiple risk factors have cumulative effect in the causing left ventricular systolic dysfunction

Keywords: Asymptomatic, Ejection fraction, High risk, Preventive Medicine, Public Health, Systolic dysfunction