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Left ventricular long axis function in diastolic heart failure is reduced in both diastole and systole: time for a

G Yip1, M Wang, Y Zhang

  • 1Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

Heart (British Cardiac Society)
|January 18, 2002
PubMed

Insights

Diastolic heart failure patients show impaired systolic function, even with normal ejection fraction. This suggests a continuum of systolic dysfunction in heart failure, with isolated diastolic dysfunction being rare.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Diastolic heart failure is characterized by preserved left ventricular ejection fraction (LVEF).
  • Systolic function is typically assessed using LVEF, but subtle abnormalities may exist.
  • Left ventricular hypertrophy is common in heart failure patients.

Purpose of the Study:

  • To investigate systolic function in patients with diastolic heart failure using longitudinal axis measurements.
  • To test the hypothesis that systolic function is abnormal in diastolic heart failure.
  • To explore the relationship between systolic and diastolic function across a spectrum of heart failure.

Main Methods:

  • A case-control study comparing 68 heart failure patients (29 diastolic, 39 systolic) and 105 controls.
  • Left ventricular ejection fraction (LVEF) measured by Simpson's method.
  • Mitral annular velocities and amplitudes assessed using tissue Doppler and M-mode echocardiography, along with mitral inflow velocities.

Main Results:

  • Patients with diastolic heart failure exhibited reduced peak systolic mitral annular velocity and amplitude compared to controls (p < 0.001).
  • These systolic parameters were significantly impaired in diastolic heart failure compared to systolic heart failure.
  • Reduced early diastolic velocity and amplitude were also observed in diastolic heart failure patients.

Conclusions:

  • Systolic left ventricular impairment is present in diastolic heart failure, detectable by longitudinal myocardial Doppler imaging.
  • Subtle systolic function abnormalities exist in heart failure with normal LVEF.
  • A continuum of systolic function is evident from normal to diastolic and systolic heart failure, with isolated diastolic dysfunction being uncommon.
Abstract

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