Document Detail

Cardiac structure and ventricular-vascular function in persons with heart failure and preserved ejection fraction from Olmsted County, Minnesota.
MedLine Citation:
PMID:  17404159     Owner:  NLM     Status:  MEDLINE    
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.
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:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-04-02
Journal Detail:
Title:  Circulation     Volume:  115     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-17     Completed Date:  2007-05-01     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1982-90     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Cross-Sectional Studies
Diabetes Mellitus / diagnosis,  epidemiology
Heart Failure / diagnosis*,  epidemiology,  physiopathology*
Heart Function Tests
Heart Ventricles / pathology,  physiopathology*
Hypertension / diagnosis*,  epidemiology
Middle Aged
Minnesota / epidemiology
Natriuretic Peptide, Brain / blood
Reference Values
Stroke Volume*
Grant Support
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comment In:
Circulation. 2007 Dec 11;116(24):e562; author reply e563   [PMID:  18071083 ]
Erratum In:
Circulation. 2007 May 22;115(20):e535

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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