Subtle Systolic Dysfunction May Be Associated with the Tendency to Develop Diastolic Heart Failure in Patients with Preserved Left Ventricular Ejection Fraction

Abstract

The question whether DHF is a reality or all heart failures are systolic may be answered as follows. Subtle systolic dysfunction may be associated with the tendency to develop DHF in patients with preserved LV ejection fraction. As in systolic heart failure (EF < 45%), in patients with preserved systolic function (EF > or = 45%), systolic and diastolic functions may impair together. The pw-TDI method may be more sensitive than standard echocardiography parameters in detection of systolic dysfunction in cases with preserved EF.

Associations Between Left Ventricular Dysfunction and Brain Structure and Function: Findings From the SABRE (Southall and Brent Revisited) Study

“…In particular, Sa is a highly sensitive and accurate measure of systolic LV function, superior to ejection fraction/stroke index, which only capture disturbed function at a later stage 30. We have expanded previous work by exploring the mechanisms through which LV function might affect brain structure/function and alternative competing pathways.…”

“…Full echocardiography data are presented in Table 1; however, 3 key LV measures were selected a priori for analysis. For systolic function, the key measure was the tissue Doppler imaging systolic wave (Sa), which was chosen for its precision and sensitivity to early long‐axis systolic dysfunction compared with ejection fraction 30. For diastolic function, left atrial diameter indexed to height was chosen because it provides a long‐term indication of the effects of chronically elevated filling pressure.…”

Cumulative Impact of Cardiovascular Risk Factors on Regional Left Ventricular Function and Reserve: Progressive Long-Axis Dysfunction with Compensatory Radial Changes

“…Unfortunately, design of our study makes impossible follow up of patients, to check if they develop symptoms of heart failure. A recent study on 300 patients with risk factors and preserved LV EF has been suggested that subtle systolic dysfunction may be associated with the tendency to develop diastolic heart failure, 32 however, further large, prospective trials, are needed to clarify the relation between impaired subendocardial function, at rest or during stress, and developing overt heart failure.…”

“…The MYDISE database includes the results of dobutamine stress echocardiographic tests performed in normal subjects with risk factors. They were either healthy volunteers 32 or they were patients who had been referred for investigation of chest pain but who were found to have normal coronary arteriography. Their probability of developing clinical coronary heart disease was low, at 11.9 ± 5.3% over 10 years 12 .…”

Perioperative Care of the Patient with Diastolic Heart Failure

“…Resting left ventricular stiffness is the resistance to stretch that occurs to counter high systolic pressures 16 . Three conditions must be present to confirm DHF: first, CHF symptoms must be detected; second, there must be preserved systolic function noted within the first 72 hours after CHF symptoms are detected; and third, there must be diastolic dysfunction 17 …”