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[Congestive heart failure with intact systolic function]
Insights
Cardiac failure can occur with normal left ventricular systolic function. This condition, seen in 26% of patients, is more common in older females with acute heart failure and hypertension.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Congestive cardiac failure is a significant clinical syndrome.
- Left ventricular systolic dysfunction is a common cause of heart failure.
- Cardiac failure with preserved systolic function is increasingly recognized.
Purpose of the Study:
- To determine the prevalence of cardiac failure with normal left ventricular systolic function.
- To document underlying mechanisms of this condition.
- To assess if clinical data can predict systolic dysfunction.
Main Methods:
- Retrospective study of 152 congestive cardiac failure patients over 4 years.
- Patients divided into two groups: abnormal (ejection fraction <45%) and normal (ejection fraction >=45%) systolic function.
- Analysis of clinical, echocardiographic, and radionuclide angiographic data.
Main Results:
- 26% of patients had cardiac failure with normal left ventricular systolic function (Group II).
- Group II patients were older, more often female, had acute cardiac failure, and were frequently hypertensive.
- Increased jugular venous pressure and cardiomegaly were more common in patients with abnormal systolic function (Group I).
Conclusions:
- Cardiac failure with normal left ventricular systolic function is prevalent.
- Specific clinical characteristics are associated with normal systolic function in heart failure.
- Further investigation into the mechanisms and predictors of this condition is warranted.
Abstract:
A retrospective study was undertaken of the cases of patients admitted for congestive cardiac failure over a 4 year period, and investigated by radionuclide angiography to determine the prevalence of cardiac failure with normal left ventricular systolic function, to document the underlying mechanisms of this condition and to assess whether the clinical data could predict the presence or absence of left ventricular systolic dysfunction. After excluding patients with significant valvular disease, severe renal failure, or myocardial infarction in the previous 2 months, the study population comprised 152 patients divided into 2 groups: Group I (N = 112) with abnormal systolic function (radionuclide ejection fraction less than 45%) and Group II (N = 40) with normal systolic function (radionuclide ejection fraction greater than or equal to 45%). The clinical, echocardiographic and radionuclide angiographic data was analysed (global ejection fraction in both groups and peak filling rate in Group II). The patients in Group II (26% of the total study population) were older (66.5 +/- 12.4 vs 61.3 +/- 12.3 years, p less than or equal to 0.02), were more often female (35% vs 17.9%, p less than or equal to 0.02), had acute cardiac failure (75% vs 37%, p less than 0.00001), and were frequently hypertensive (65% vs 39%, p less than or equal to 0.005). Univariate analysis of clinical and radiological signs did not show any significant difference between the two groups except for increased jugular venous pressure and cardiomegaly which were more common in Group I (56% vs 25%, p less than 0.00001 and 93% vs 68%, p less than or equal to 0.00001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)