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Updated: Aug 15, 2026
A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models
Published on: July 21, 2023
Systolic and diastolic functions in elderly patients with and without heart failure
Paolo Giovanardi1, Carlo Di Donato, Romeo Giulietto Zennaro
11st Internal Medicine Division-St. Agostino-Estense Hospital, Modena, Italy. p.giovanardi@ausl.mo.it
Insights
Diastolic heart failure (DHF) is common in elderly patients with heart failure (HF), even with normal left ventricular ejection fraction (LVEF). Diastolic dysfunction (DDYS) is present in all HF patients and worsens as LVEF decreases.
Area of Science:
- Cardiology
- Geriatrics
- Echocardiography
Background:
- A significant portion of heart failure (HF) patients exhibit normal left ventricular ejection fraction (LVEF).
- Diastolic heart failure (DHF) is often implicated in these cases but remains underdiagnosed.
- Diastolic dysfunction (DDYS) is a key factor in HF with preserved ejection fraction.
Purpose of the Study:
- To evaluate clinical, instrumental, and echocardiographic findings in elderly patients admitted with and without heart failure.
- To investigate the prevalence and characteristics of diastolic dysfunction (DDYS) in elderly patients.
- To explore the relationship between left ventricular ejection fraction (LVEF) and DDYS severity.
Main Methods:
- Retrospective analysis of 159 consecutive hospitalized elderly patients.
- Clinical assessment and conventional echocardiography were performed.
- Patients were categorized into heart failure (HF) and non-HF groups.
Main Results:
- All 87 HF patients displayed signs of diastolic dysfunction (DDYS); 44.8% had normal LVEF.
- Among 72 non-HF patients, 61.1% had mild DDYS and 14% had reduced LVEF.
- A significant correlation was observed between reduced LVEF and increased DDYS severity.
Conclusions:
- Heart failure (HF) frequently involves combined diastolic and systolic dysfunction.
- Diastolic heart failure (DHF) can be subtle in HF patients with normal LVEF.
- Diastolic dysfunction (DDYS) serves as a marker for all HF types, particularly in the elderly.
Background:
A considerable number of patients with heart failure (HF) have a normal left ventricular ejection fraction (LVEF). In these subjects, HF has usually been related to diastolic heart failure (DHF), still a frequently overlooked clinical entity.
Methods:
This study reports the clinical, instrumental, and conventional echocardiographic evaluation of 159 consecutive, hospitalized elderly patients, 87 admitted with HF and 72 admitted for other reasons without overt HF.
Results:
All of the 87 HF patients had signs of diastolic dysfunction (DDYS), yet 44.8% of them had a normal LVEF. Forty-four of the 72 patients admitted without overt HF (61.1%) had mild DDYS and 14 (19.5%) also had a reduced LVEF. There was a clear relationship between LVEF reduction and the severity of DDYS.
Conclusions:
HF is often a combination of diastolic and systolic function abnormalities. DHF may be difficult to detect in HF subjects with normal LVEF because their DDYS is often mild. However, there are signs of DDYS in all HF patients that increase in severity as LVEF decreases. DDYS could be considered a marker for all forms of HF, especially in elderly patients.
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