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Subtle systolic dysfunction may be associated with the tendency to develop diastolic heart failure in patients with

Hüseyin Sürücü1, Ersan Tatli, Ali Değirmenci

  • 1Cardiology Department, Private Avcilar Anadolu Hospital, Istanbul, Turkey. huseyinsurucu@yahoo.com.tr

Echocardiography (Mount Kisco, N.Y.)
|April 23, 2009
PubMed

Insights

Diastolic heart failure (DHF) is a distinct condition, not solely systolic. Subtle systolic dysfunction can precede DHF in patients with preserved ejection fraction (EF), indicating combined systolic and diastolic impairment.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Heart Failure Pathophysiology

Background:

  • Investigated the existence of diastolic heart failure (DHF) versus solely systolic heart failure.
  • Examined patients with preserved left ventricular ejection fraction (LVEF) at risk for DHF.

Purpose of the Study:

  • To determine if diastolic heart failure (DHF) is a distinct entity.
  • To explore the relationship between pulmonary capillary wedge pressure (PCWP) and cardiac function in patients with preserved LVEF.
  • To assess the utility of pulsed wave tissue Doppler imaging (pw-TDI) in detecting subtle cardiac dysfunction.

Main Methods:

  • Evaluated 180 patients with preserved LVEF, categorized into three groups based on noninvasively obtained pulmonary capillary wedge pressure (PCWP).
  • Utilized transmitral flow velocities and pulsed wave tissue Doppler imaging (pw-TDI) parameters to assess diastolic and systolic function.
  • Analyzed relationships between PCWP, transmitral velocities (E, A), and pw-TDI parameters (Ea, Ea-dt, Sa, Q-Sa).

Main Results:

  • Higher PCWP correlated with increased transmitral A velocity and prolonged Ea-dt, indicative of diastolic dysfunction.
  • Lower PCWP was associated with higher transmitral E velocity.
  • Progressively decreased Sa velocity and prolonged Q-Sa intervals were observed with increasing PCWP, suggesting systolic dysfunction.

Conclusions:

  • Subtle systolic dysfunction may be linked to the development of DHF in patients with preserved LVEF.
  • Systolic and diastolic functions can impair concurrently in patients with preserved systolic function (LVEF ≥ 45%).
  • Pulsed wave tissue Doppler imaging (pw-TDI) demonstrates higher sensitivity than standard echocardiography for detecting systolic dysfunction in preserved LVEF.
Abstract

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