| Cardiac structure and ventricular-vascular function in persons with heart failure and preserved ejection fraction from Olmsted County, Minnesota. | |
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MedLine Citation:
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PMID: 17404159 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mechanisms purported to contribute to the pathophysiology of heart failure with normal ejection fraction (HFnlEF) include diastolic dysfunction, vascular and left ventricular systolic stiffening, and volume expansion. We characterized left ventricular volume, effective arterial elastance, left ventricular end-systolic elastance, and left ventricular diastolic elastance and relaxation noninvasively in consecutive HFnlEF patients and appropriate controls in the community. METHODS AND RESULTS: Olmsted County (Minn) residents without cardiovascular disease (n=617), with hypertension but no heart failure (n=719), or with HFnlEF (n=244) were prospectively enrolled. End-diastolic volume index was determined by echo Doppler. End-systolic elastance was determined using blood pressure, stroke volume, ejection fraction, timing intervals, and estimated normalized ventricular elastance at end diastole. Tissue Doppler e' velocity was used to estimate the time constant of relaxation. End-diastolic volume (EDV) and Doppler-derived end-diastolic pressure (EDP) were used to derive the diastolic curve fitting (alpha) and stiffness (beta) constants (EDP=alphaEDVbeta). Comparisons were adjusted for age, sex, and body size. HFnlEF patients had more severe renal dysfunction, yet smaller end-diastolic volume index and cardiac output and increased EDP compared with both hypertensive and healthy controls. Arterial elastance and ventricular end-systolic elastance were similarly increased in hypertensive controls and HFnlEF patients compared with healthy controls. In contrast, HFnlEF patients had more impaired relaxation and increased diastolic stiffness compared with either control group. CONCLUSIONS: From these cross-sectional observations, we speculate that the progression of diastolic dysfunction plays a key role in the development of heart failure symptoms in persons with hypertensive heart disease. |
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Authors:
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Carolyn S P Lam; Véronique L Roger; Richard J Rodeheffer; Francesca Bursi; Barry A Borlaug; Steve R Ommen; David A Kass; Margaret M Redfield |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2007-04-02 |
Journal Detail:
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Title: Circulation Volume: 115 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-17 Completed Date: 2007-05-01 Revised Date: 2010-12-03 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1982-90 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Comorbidity Cross-Sectional Studies Diabetes Mellitus / diagnosis, epidemiology Female Heart Failure / diagnosis*, epidemiology, physiopathology* Heart Function Tests Heart Ventricles / pathology, physiopathology* Humans Hypertension / diagnosis*, epidemiology Male Middle Aged Minnesota / epidemiology Natriuretic Peptide, Brain / blood Reference Values Stroke Volume* |
| Grant Support | |
ID/Acronym/Agency:
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HL55502-7/HL/NHLBI NIH HHS; HL63281-4/HL/NHLBI NIH HHS; HL72435-2/HL/NHLBI NIH HHS; R01 HL063281-04/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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114471-18-0/Natriuretic Peptide, Brain |
| Comments/Corrections | |
Comment In:
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Circulation. 2007 Dec 11;116(24):e562; author reply e563
[PMID:
18071083
]
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Erratum In:
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Circulation. 2007 May 22;115(20):e535 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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