Echocardiographic Features of Patients With Congestive Heart Failure and Preserved Left Ventricular Pump Function: A Retrospective Study in a Selected Common Disease Cohort

Abstract

IntroductionWith respect to the recent clinical issue of isolated left ventricular (LV) diastolic dysfunction, many studies have reported that 30% to 40% of patients with congestive heart failure (CHF) have preserved LV systolic function [1][2][3]. When pulmonary congestion, that is, an increase in left atrial pressure, is observed in such patients, the transmitral flow (TMF) velocity shows a pseudonormalized or restrictive pattern in many of the patients [4,5]. However, in clinical practice, the peak early diastolic TMF velocity (E) is lower than the peak atrial systolic TMF velocity (A) (E/A<1) in most patients with LV diastolic dysfunction, suggesting relaxation abnormalities. Therefore, it is difficult to predict whether isolated diastolic dysfunction will cause CHF in the future in individual patients with E/A<1. Douglas [6] indicated that the left atrial size reflects the history of LV diastolic dysfunction, and that the level of left atrial enlargement is associated with the serum HbA1c concentration in patients with diabetes. The development of ultrasonic strain imaging has facilitated the evaluation of regional myocardial systolic and diastolic function and is not influenced by whole heart motion or tethering [7]. In the present study, we divided patients, in whom LV pump function was maintained with TMF showing a relaxation abnor- AbstractBackground. Little is known of the pathophysiologic characteristics of a common disease cohort with congestive heart

Determinants of plasma brain natriuretic peptide levels in untreated hypertensive patients

“…The most important cardiovascular event that hypertension contributes to is chronic heart failure [1]. Diastolic dysfunction is usually observed in hypertensive patients even at an early stage, and its progression as well as its association with systolic dysfunction cause chronic heart failure [2,3]. Plasma brain natriuretic peptide (BNP) levels increase in patients with heart failure; thus, measurements of BNP levels are useful in the management of patients with heart failure [4,5].…”