Left ventricular ejection fraction and left ventricular end-diastolic volume in patients with diastolic dysfunction

Area of Science:

• Cardiology
• Nuclear Cardiology
• Cardiovascular Imaging

Background:

• Diastolic dysfunction is often diagnosed using equilibrium radionuclide angiocardiography (ERNA) by identifying a low peak filling rate (PFR) when left ventricular ejection fraction (LVEF) is normal.
• Understanding the relationship between diastolic dysfunction, LVEF, and end-diastolic volume (EDV) is crucial for patient management.

Purpose of the Study:

• To evaluate the association between diastolic dysfunction (indicated by PFR), LVEF, and EDV in asymptomatic patients.
• To determine if a low PFR in patients with normal LVEF is related to EDV or mild systolic dysfunction.

Main Methods:

• Studied 408 predominantly asymptomatic patients with LVEF ≥50% using ERNA.
• Compared LVEF in patients with low PFR versus normal PFR.
• Performed correlation analyses between PFR and EDV, including EDV indices and changes over time in repeat scans.

Main Results:

• Patients with a low PFR exhibited a significantly lower LVEF (59±7%) compared to those with a normal PFR (63%±7%; P<.01).
• No significant correlation was found between EDV and PFR (r=-0.04; P=.32), even when using EDV indices.
• Repeat scans showed no correlation between changes in EDV and changes in PFR (r=0.16; P=.2).

Conclusions:

• In asymptomatic individuals with normal systolic function by ERNA, a low PFR is associated with a reduced LVEF.
• Diastolic dysfunction, identified by low PFR, is not associated with altered EDV in this cohort.
• These findings suggest that diastolic dysfunction may coexist with mild systolic dysfunction.