Document Detail

Lack of diastolic reserve in patients with heart failure and normal ejection fraction.
MedLine Citation:
PMID:  19850696     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The genesis of symptoms in patients with heart failure (HF) and normal ejection fraction (HFNEF) is unclear. Most investigations of HFNEF have focused on cardiac function at rest although most of these patients are breathless only on exercise. Stress-induced impairment in systolic or diastolic function could result in these symptoms. Method and Result- Forty-one patients with HFNEF and 29 controls underwent dobutamine stress echocardiography with color tissue Doppler imaging. Wall motion score index and regional myocardial systolic velocity (Sm) were measured at and peak stress. Systolic (Sa), early diastolic (Ea), and late diastolic (Aa) mitral annular velocities were averaged over the 6 periannular sites. Mitral annular long-axis velocity was lower in the HFNEF than controls at rest. Global, regional, and long-axis systolic function did not worsen with stress in the HFNEF group. The Ea decreased and the E/Ea increased with stress in the HFNEF but not in controls. The 6-minute walk distance was shorter and negatively correlated to the E/EA ratio at rest and stress in the HFNEF group.
CONCLUSIONS: Impaired diastolic reserve results in stress-induced increase in the left ventricular end-diastolic pressure in patients with HFNEF giving rise to exercise intolerance.
Sudipta Chattopadhyay; Mohammed F Alamgir; Nikolay P Nikitin; Alan S Rigby; Andrew L Clark; John G F Cleland
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-22
Journal Detail:
Title:  Circulation. Heart failure     Volume:  3     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-20     Completed Date:  2010-02-16     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-43     Citation Subset:  IM    
Department of Cardiology, University of Hull, Kingston-upon-Hull, United Kingdom.
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MeSH Terms
Case-Control Studies
Echocardiography, Doppler, Color
Echocardiography, Stress
Exercise Tolerance*
Heart Failure / physiopathology*,  ultrasonography*
Stroke Volume
Grant Support
PG/2001/1088//British Heart Foundation

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

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