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Left ventricular diastolic dysfunction in patients with congestive heart failure.
L L Cregler1, D Georgiou, I Sosa
1Department of Medicine, Bronx VA Medical Center, New York.
Journal of the National Medical Association
|January 1, 1991
Summary
Many patients with congestive heart failure have diastolic dysfunction, not systolic dysfunction. Recognizing diastolic heart failure is crucial for effective treatment and improved prognosis in these patients.
Area of Science:
- Cardiology
- Heart Failure Research
Background:
- Congestive heart failure (CHF) affects numerous patients, often attributed to systolic dysfunction.
- Distinguishing between systolic and diastolic heart failure is critical due to differing pathophysiology, treatment, and prognosis.
Purpose of the Study:
- To identify the prevalence of diastolic heart failure in patients meeting Framingham criteria for CHF.
- To highlight the importance of recognizing diastolic dysfunction in specific patient populations.
Main Methods:
- Retrospective review of 372 male patients diagnosed with congestive heart failure.
- Assessment of cardiac function using radionuclide angiography to determine ejection fraction.
Main Results:
- 77% of patients had CHF due to systolic dysfunction.
- 23% of patients had CHF with normal ejection fractions, indicating unrecognized diastolic heart failure.
- Hypertension was the most frequent cause of diastolic heart failure in this cohort.
Conclusions:
- Diastolic heart failure is a significant, often unrecognized, condition in patients with CHF.
- Consider diastolic dysfunction in acute heart failure with severe hypertension or pulmonary edema in ischemic heart disease.
- Patients unresponsive to conventional therapy may have diastolic dysfunction requiring tailored management.