Document Detail


Role of left ventricular stiffness in heart failure with normal ejection fraction.
MedLine Citation:
PMID:  18413502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increased left ventricular stiffness is a distinct finding in patients who have heart failure with normal ejection fraction (HFNEF). To elucidate how diastolic dysfunction contributes to heart failure symptomatology during exercise, we conducted a study using an invasive pressure-volume loop approach and measured cardiac function at rest and during atrial pacing and handgrip exercise. METHODS AND RESULTS: Patients with HFNEF (n=70) and patients without heart failure symptoms (n=20) were enrolled. Pressure-volume loops were measured with a conductance catheter during basal conditions, handgrip exercise, and atrial pacing with 120 bpm to analyze diastolic and systolic left ventricular function. During transient preload reduction, the diastolic stiffness constant was measured directly. Diastolic function with increased stiffness was significantly impaired in patients with HFNEF during basal conditions. This was associated with increased end-diastolic pressures during handgrip exercise and with decreased stroke volume and a leftward shift of pressure-volume loops during atrial pacing. CONCLUSIONS: Increased left ventricular stiffness contributed to increased end-diastolic pressure during handgrip exercise and decreased stroke volume during atrial pacing in patients with HFNEF. These data suggest that left ventricular stiffness modulates cardiac function in HFNEF patients and suggests that diastolic dysfunction with increased stiffness is a target for treating HFNEF.
Authors:
Dirk Westermann; Mario Kasner; Paul Steendijk; Frank Spillmann; Alexander Riad; Kerstin Weitmann; Wolfgang Hoffmann; Wolfgang Poller; Matthias Pauschinger; Heinz-Peter Schultheiss; Carsten Tschöpe
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-04-14
Journal Detail:
Title:  Circulation     Volume:  117     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-22     Completed Date:  2008-05-15     Revised Date:  2009-02-06    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2051-60     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology and Pneumology, Benjamin Franklin Campus, Charité University Hospital, Hindenburgdamm 30, 12200 Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathies / physiopathology,  ultrasonography
Diastole / physiology*
Echocardiography, Doppler
Exercise
Female
Hand Strength
Heart Failure, Diastolic / physiopathology*,  ultrasonography
Humans
Male
Middle Aged
Pacemaker, Artificial
Rest
Stroke Volume / physiology*
Systole / physiology
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography
Ventricular Function, Left / physiology
Comments/Corrections
Comment In:
Circulation. 2009 Jan 6;119(1):e4; author reply e5   [PMID:  19124669 ]
Circulation. 2008 Apr 22;117(16):2044-6   [PMID:  18427141 ]

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


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