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Left ventricular systolic function is abnormal in diastolic heart failure: re-assessment of systolic function using

Mihoko Kono1, Akira Kisanuki, Kunitsugu Takasaki

  • 1Department of Cardiovascular, Respiratory and Metabolic Medicine, Kagoshima University, Kagoshima City, Japan.

Journal of Cardiology
|May 30, 2009
PubMed

Insights

Diastolic heart failure (DHF) involves systolic dysfunction and left ventricular (LV) enlargement, not just diastolic issues. This study highlights that impaired LV systolic function is crucial in DHF development.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Diastolic heart failure (DHF) is characterized by preserved left ventricular (LV) ejection fraction (EF).
  • EF may not accurately represent systolic function in DHF, particularly with isovolumetric contraction time (ICT) abnormalities.

Purpose of the Study:

  • To re-evaluate left ventricular (LV) systolic function in diastolic heart failure (DHF) using Doppler echocardiography.
  • To identify key differences in systolic function between DHF, asymptomatic diastolic dysfunction (ADD), and normal controls.

Main Methods:

  • Doppler echocardiography was used to assess LV systolic and diastolic function in 80 DHF patients, 30 ADD patients, and 30 controls.
  • Measurements included LV and left atrial volumes, LV EF, LV ICT, isovolumetric relaxation time (IRT), mitral flow velocities, and mitral annular velocities (S').

Main Results:

  • Left ventricular (LV) isovolumetric contraction time (ICT) was significantly increased in DHF patients compared to ADD and control groups (P<0.0001).
  • LV end-diastolic volume index was significantly higher in DHF patients.
  • Systolic mitral annular velocity (S') was significantly decreased in both DHF and ADD groups compared to controls.

Conclusions:

  • Diastolic heart failure (DHF) is associated with global and longitudinal LV systolic dysfunction and LV enlargement, distinguishing it from asymptomatic diastolic dysfunction (ADD).
  • The findings suggest that impaired LV systolic function is a significant contributor to the development of DHF.
Abstract

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