Document Detail


Diastolic dysfunction and autonomic abnormalities in patients with systolic heart failure.
MedLine Citation:
PMID:  17123863     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with systolic heart failure (SHF) often have concomitant diastolic dysfunction (DD). SHF is associated with decreased heart rate variability (HRV), but the impact of degree of DD on HRV in SHF is unclear.
METHODS AND RESULTS: HRV was measured in 139 patients, aged 64+/-12 years, 74% male, LVEF 30+/-8%. Patients had stable NYHA class II-III CHF on ACE inhibitors or ATII receptor blockers, with LVEF<or=40% and BNP>or=200 pg/ml. Subjects underwent 2-D echocardiography with Doppler assessment and 24-h Holters. Patients were categorized as having impaired relaxation (E-deceleration time>2 SD above age-adjusted normal values (AANV), E/A<or=1, systolic/diastolic pulmonary vein flow>or=1; N=30), pseudonormal (E-deceleration time within 2 SD of AANV, E/A=1-2, systolic/diastolic pulmonary vein flow<1; N=25) or restrictive filling patterns (E-deceleration time>2 SD below AANV or/and E/A ratio>or=2; N=84) Differences were adjusted for clinical covariates using UNIANOVA, p<0.05. HRV was reduced and BNP higher in pseudonormal patients compared to impaired relaxation, but this difference was only significant for restrictive vs. impaired filling. Differences remained significant after adjustment for covariates.
CONCLUSION: Significantly more abnormal HRV, reflecting greater cardiac autonomic dysfunction, is associated with restrictive DD compared to impaired relaxation.
Authors:
Phyllis K Stein; Larisa Tereshchenko; Peter P Domitrovich; Robert E Kleiger; Alfonso Perez; Prakash Deedwania
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Publication Detail:
Type:  Journal Article     Date:  2006-11-22
Journal Detail:
Title:  European journal of heart failure     Volume:  9     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-11-13     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  364-9     Citation Subset:  IM    
Affiliation:
Washington University School of Medicine, St. Louis, MO 63108, USA. pstein@im.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors
Autonomic Nervous System / physiopathology*
Diastole / drug effects
Female
Heart Failure / etiology,  physiopathology*,  ultrasonography
Heart Rate
Humans
Male
Middle Aged
Pilot Projects
Systole / drug effects
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors

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