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Improved Diastolic Function Is Associated With Higher Cardiac Output in Patients With Heart Failure Irrespective of

Tomoyuki Tobushi1, Masatsugu Nakano2, Kazuya Hosokawa3

  • 1Department of Cardiology, Aso-Iizuka Hospital, Iizuka Fukuoka, Japan ttobushi@gmail.com.

Journal of the American Heart Association
|March 2, 2017
PubMed

Insights

Diastolic function significantly impacts cardiac output (CO) in heart failure patients, regardless of ejection fraction (EF). Improving diastolic function, measured by end-diastolic pressure-volume relationship (EDPVR), increases CO, highlighting its importance in heart failure management.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Hemodynamics

Background:

  • Limited understanding of diastolic function's effect on cardiac output (CO) in heart failure (HF), especially with reduced ejection fraction (EF).
  • The role of end-diastolic pressure-volume relationship (EDPVR) in modulating CO and end-diastolic pressure (EDP) in HF patients is not well-defined.

Purpose of the Study:

  • To investigate the impact of end-diastolic pressure-volume relationship (EDPVR) on cardiac output (CO) and end-diastolic pressure (EDP) in heart failure patients.
  • To assess how diastolic function influences CO across different ejection fraction (EF) ranges.

Main Methods:

  • Retrospective analysis of 1840 heart catheterization patients.
  • Patients categorized into 8 groups based on EF (35-45%, 46-55%, 56-65%, 66-75%) and EDP (>16 or ≤16 mmHg).
  • EDPVR estimated from catheterization data; EDPVRs of high-EDP groups were normalized to assess CO changes.

Main Results:

  • Normalized EDPVR significantly increased CO at an EDP of 10 mmHg across all EF groups.
  • Observed increases in CO were consistent irrespective of the ejection fraction range.
  • Changes in CO following EDPVR normalization were similar across different EF strata.

Conclusions:

  • Normalization of diastolic function is associated with improved CO in heart failure patients, independent of EF.
  • Diastolic dysfunction significantly influences CO determination in heart failure, regardless of ejection fraction.
  • EDPVR serves as a critical determinant of cardiac output in heart failure management.
Abstract

Keywords:
cardiac outputdiastolic dysfunctionheart failure

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