Document Detail


Decreased left ventricular distensibility in response to postural change in older patients with heart failure and preserved ejection fraction.
MedLine Citation:
PMID:  20562334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Most elderly persons with heart failure have a preserved left ventricular (LV) ejection fraction (HFPEF). The pathophysiology of this disorder is not well understood, and there are conflicting data regarding the role of decreased LV distensibility. To assess LV distensibility over a range of preload conditions while minimizing the large, confounding changes in contractility, afterload, and heart rate characteristic of exercise, we measured LV end-diastolic volume (EDV), stroke volume (SV), and cardiac output (CO) using two-dimensional echocardiography in 48 elderly (mean age, 69 yr) HFPEF patients and 25 healthy age-matched controls during quiet supine rest, 45 degrees head-up tilt (HUT), and 45 degrees head-down tilt (HDT). As a result, when compared with controls, HFPEF patients had reduced percent changes in EDV (-7 +/- 2 vs. -17 +/- 2%; P = 0.003), SV (-7 +/- 3 vs. -27 +/- 2%; P = 0.003), and CO (-6 +/- 4 vs. -34 +/- 4%; P = 0.001) during the transition from supine to HUT. HFPEF also had reduced percent changes in EDV (8 +/- 2 vs. 15 +/- 2%; P = 0.02), SV (11 +/- 3 vs. 21 +/- 3%; P = 0.002), and CO (1 +/- 4 vs. 12 +/- 4%; P = 0.04) during the transition from HUT to HDT. In conclusion, HFNEF patients have reduced LV distensibility in response to postural change, resulting in blunted EDV, SV, and CO. This provides further support for the hypothesis that a blunted Frank-Starling mechanism may contribute to the pathophysiology of HFPEF.
Authors:
Jerry M John; Mark Haykowsky; Peter Brubaker; Kathy Stewart; Dalane W Kitzman
Related Documents :
16996844 - Adjunctive therapy with low-molecular-weight heparin in patients with chronic heart fai...
9882774 - Difference in the diastolic left ventricular wall motion velocities between aortic and ...
20103244 - Cardiac function assessed by transesophageal echocardiography during pectus excavatum r...
23678214 - Is rheumatic mitral valve repair still a feasible alternative?: indications, technique,...
10728414 - Alterations in ca2+ cycling proteins and g alpha q signaling after left ventricular ass...
17034064 - Efficacy of intracoronary nicardipine in the treatment of no-reflow during percutaneous...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-06-18
Journal Detail:
Title:  American journal of physiology. Heart and circulatory physiology     Volume:  299     ISSN:  1522-1539     ISO Abbreviation:  Am. J. Physiol. Heart Circ. Physiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-22     Revised Date:  2012-05-17    
Medline Journal Info:
Nlm Unique ID:  100901228     Medline TA:  Am J Physiol Heart Circ Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  H883-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, University of Toledo, Toledo, Ohio, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Echocardiography
Female
Heart Failure / physiopathology*
Heart Ventricles / physiopathology*
Humans
Male
Patient Selection
Posture / physiology*
Stroke Volume / physiology*
Tilt-Table Test
Ventricular Dysfunction, Left / physiopathology*
Grant Support
ID/Acronym/Agency:
5T32-HL-076132-02/HL/NHLBI NIH HHS; AG-12257/AG/NIA NIH HHS; MO1-RR-07122/RR/NCRR NIH HHS; P30-AG-21332/AG/NIA NIH HHS; R37 AG018915/AG/NIA NIH HHS; R37-AG-18915/AG/NIA NIH HHS
Comments/Corrections

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


Previous Document:  Luminal endothelial lectins with affinity for N-Acetylglucosamine determine flow-induced cardiac and...
Next Document:  Wave intensity analysis of right ventricular and pulmonary vascular contributions to higher pulmonar...