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"Diastolic heart failure" or heart failure caused by subtle left ventricular systolic dysfunction?
M C Petrie1, L Caruana, C Berry
1Department of Cardiology, Western Infirmary of Glasgow, Glasgow, UK.
Heart (British Cardiac Society)
|December 26, 2001
Summary
A new echocardiographic measure revealed subtle systolic dysfunction in approximately one quarter of patients with suspected heart failure and preserved systolic function. This suggests heart failure may stem from systolic issues, not just diastolic dysfunction.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Heart failure with preserved ejection fraction (HFpEF) is often attributed to diastolic dysfunction.
- Subtle left ventricular systolic dysfunction may be overlooked by conventional echocardiographic measures.
Purpose of the Study:
- To investigate if left ventricular systolic atrioventricular plane displacement (SAVD) can detect subtle systolic dysfunction in patients with suspected heart failure and preserved systolic function.
- To differentiate between isolated diastolic dysfunction and subtle systolic dysfunction in this patient group.
Main Methods:
- Observational study involving 147 patients with suspected heart failure.
- Echocardiography was used to assess conventional systolic function measures (fractional shortening, ejection fraction) and SAVD.
Main Results:
- Between 21% and 33% of patients with normal systolic function by conventional methods showed abnormal SAVD.
- Abnormal SAVD suggests underlying subtle left ventricular systolic dysfunction.
Conclusions:
- A significant proportion of patients with suspected heart failure and preserved systolic function exhibit abnormal SAVD.
- This finding challenges the concept of isolated diastolic heart failure, indicating potential subtle systolic dysfunction as a cause.