Reduced systolic performance by tissue Doppler in patients with preserved and abnormal ejection fraction: New insights in chronic heart failure

García, Edgar; Perna, Eduardo R.; Farías, Eduardo; Obregón, Ricardo; Macin, Stella M.; Parras, Jorge I.; Agüero, Marcelo A.; Moratorio, Diego A.; Pitzus, Ariel E.; Tassano, Eduardo A.; Rodriguez, L. Leonardo

doi:10.1016/j.ijcard.2005.04.026

Cited by 70 publications

(49 citation statements)

References 25 publications

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“…Several recent studies have demonstrated that the majority of patients with DHF have associated subclinical systolic dysfunction, which can be assessed by TDI. [5][6][7][8][9][10][11] Thus, it likely appears that isolated diastolic dysfunction is uncommon, and that the main difference between systolic and diastolic HF is the severity of LV remodeling (increase in ventricular volume and change in shape) and the degree of LV systolic dysfunction. 20 In the present study, we sought to determine the prevalence of subclinical systolic dysfunction in hypertensive patients with normal LVEF and no history of HF using mitral annular velocity recordings from 4 sites in the apical 4-and 2-chamber views.…”

Section: Discussionmentioning

confidence: 99%

Subclinical Left Ventricular Longitudinal Systolic Dysfunction in Hypertension With No Evidence of Heart Failure

Nishikage

Nakai

Lang

et al. 2008

Circ J

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Section: Discussionmentioning

confidence: 99%

Subclinical Left Ventricular Longitudinal Systolic Dysfunction in Hypertension With No Evidence of Heart Failure

Nishikage

Nakai

Lang

et al. 2008

Circ J

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“…However, several studies in patients with HFpEF have performed detailed examinations using echocardiography and/or cardiac magnetic resonance imaging. The results demonstrated that LV systolic function is impaired in patients with much higher LVEF levels than LVEF 50% 3, 4, 5. In addition, we previously reported loss of inertia force of late systolic aortic flow (IFLAF), which was obtained by using a catheter‐tipped micromanometer in cardiac catheterization, as a predictor of development of HF in patients with preserved LVEF 6.…”

Section: Introductionmentioning

confidence: 91%

The prognostic value of brain natriuretic peptide in patients with heart failure and left ventricular ejection fraction higher than 60%: a sub‐analysis of the J‐MELODIC study

et al. 2017

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AimsCardiac function varies in the population of patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF; HFpEF). This study investigated the heterogeneity of clinical features associated with HF and the prognostic value of BNP levels in patients with HFpEF.Methods and resultsThe study enrolled 288 patients with stable HF and serum creatinine <1.5 mg/dL who were part of the original J‐MELODIC study cohort. They were categorized as having HF with reduced LVEF (HFrEF; EF ≤ 40%, n = 83) or as having HFpEF (EF > 40%, n = 205). Patients with HFpEF were further categorized as having relatively low LVEF (HFrlEF; EF 40–60%, n = 107) or as having relatively high LVEF (HFrhEF; EF ≥ 60%, n = 98). We defined cardiovascular death and hospitalization for HF as adverse events and evaluated the prognostic value of the BNP levels in each group. There was no significant difference in event‐free survival between HFpEF and HFrEF patients or between HFrhEF and HFrlEF patients. A multivariate Cox proportional hazards model revealed that the BNP level was an independent predictor of adverse events in HFrEF patients (hazard ratio: 4.088, 95% confidence interval: 1.178–14.179, P = 0.027) and in HFrlEF patients (hazard ratio: 14.888, 95% confidence interval: 4.969–44.608, P < 0.001) but not in HFrhEF patients (P = 0.767).ConclusionsThe BNP level has prognostic value in HFrlEF but not in HFrhEF. This indicates that HFrhEF and HFrlEF are distinct entities that may require different approaches for the management of HF.

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“…Other factors -both cardiac and extracardiac -including increased arterial stiffness, altered ventricular-arterial coupling [42,43], endothelial dysfunction, reduced vasodilator reserve [44,45] and chronotropic incompetence [46,47] have been recently implicated in the pathophysiology of this complex syndrome. Furthermore, coexisting abnormalities in LV regional systolic function assessed by various parameters have been documented in HFpEF [13,15,17,18,[48][49][50].…”

Section: Pathophysiologymentioning

confidence: 99%

Heart Failure with Preserved Ejection Fraction

Čulić

2017

N Engl J Med

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Heart failure with preserved ejection fraction (HFpEF) has recently emerged as a major cause of cardiovascular morbidity and mortality. Contrary to initial beliefs, HFpEF is now known to be as common as heart failure with reduced ejection fraction (HFrEF) and carries an unacceptably high mortality rate. With a prevalence that has been steadily rising over the past two decades, it is very likely that HFpEF will represent the dominant heart failure phenotype over the coming few years. The scarcity of trials in this semi-discrete form of heart failure and lack of unified enrolment criteria in the studies conducted to date might have contributed to the current absence of specific therapies. Understanding the epidemiological, pathophysiological and molecular differences (and similarities) between these two forms of heart failure is cornerstone to the development of targeted therapies. Carefully designed studies that adhere to unified diagnostic criteria with the recruitment of appropriate controls and adoption of practical end-points are urgently needed to help identify effective treatment strategies.

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Reduced systolic performance by tissue Doppler in patients with preserved and abnormal ejection fraction: New insights in chronic heart failure

Cited by 70 publications

References 25 publications

Subclinical Left Ventricular Longitudinal Systolic Dysfunction in Hypertension With No Evidence of Heart Failure

Subclinical Left Ventricular Longitudinal Systolic Dysfunction in Hypertension With No Evidence of Heart Failure

The prognostic value of brain natriuretic peptide in patients with heart failure and left ventricular ejection fraction higher than 60%: a sub‐analysis of the J‐MELODIC study

Heart Failure with Preserved Ejection Fraction

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